Structural and Molecular Effects of Dextrose on Cartilage: A Scoping Review

Dextrose prolotherapy has been used in the treatment of individuals with osteoarthritis in various locations, reporting favorable therapeutic effects. However, the molecular and/or structural effects of dextrose prolotherapy on cartilage are still unclear. Therefore, this study aimed to analyze the molecular and/or structural effects of dextrose on cartilage and clarify the possible mechanisms of action of dextrose prolotherapy.

A systematic search was conducted using scientific databases, including PubMed, Web of Science, Cochrane Central Register of Controlled Trials, and ScienceDirect, up until November 2024, using the PRISMA-ScR for Scoping Reviews.

Twenty-three studies that evaluated the molecular and/or structural effects of dextrose on cartilage were eligible for inclusion. Fifteen studies included in vitro models, three studies involved animal models, and five studies were conducted on humans. Sixteen studies reported favorable effects on cartilage, and seven studies reported unfavorable effects. In all studies performed in vivo (in animals or humans), predominantly favorable effects on cartilage were reported. The favorable effects on cartilage were improved glucose metabolism in chondrocytes, increased deposition of extracellular matrix and the induction of chondrocyte proliferation, increased expression of anabolic growth factors and anti-inflammatory cytokines, as well as decreased activity of some metalloproteinases. Among the unfavorable effects, increased release of proinflammatory and catabolic cytokines was reported.

These results suggest that dextrose may have a therapeutic effect on cartilage, though the underlying mechanisms are not fully understood. This study is a starting point for future experimental studies evaluating the therapeutic effects of dextrose prolotherapy.