Ultrasound Guided Pes Anserine Bursitis Injection Choices; Prolotherapy or Oxygen-Ozone or Corticosteroid: A Randomized Multicenter Clinical Trial

Abstract

Abstract Objective Pes anserine bursitis (PAB) is the most common cause of periarticular knee pain. The aim of the study was to evaluate the efficacy of local injection-based therapies with different materials. Design The enrolled patients were randomly allocated to three groups to receive different interventions. Outcome measures included pain severity using the visual analog scale (VAS) and the Western Ontario McMaster Universities osteoarthritis index (WOMAC) that was evaluated before the intervention, one and eight weeks after that. Results This trial was performed on 72 participants, with male to female ratio of 0.14 and with a mean age of 61.49 ± 9.35 years old. In the first group, corticosteroids in the second group, oxygen–ozone (O2–O3), and in the third group, dextrose 20% was injected into the pes anserine bursa under ultrasound guidance. Interaction between time and group showed a statistically significant improvement in VAS and WOMAC (P ≤ 0.05) in favor of corticosteroids and O2–O3 groups after one week and in favor of O2–O3 and prolotherapy groups after eight weeks. Conclusion All three treatment options are effective for patients with PAB. This study showed that the effects of O2–O3 injection and prolotherapy last longer than those of corticosteroid injection.