Outcomes of Platelet-Rich Plasma Versus Dextrose 10% Prolotherapy in the Treatment of Osgood-Schlatter Disease: A Retrospective Study.

BACKGROUND: Osgood-Schlatter disease (OSD) is a common overuse injury affecting adolescents engaged in physical activities. While conservative treatment remains the standard, refractory cases may benefit from regenerative therapies, such as platelet-rich plasma (PRP) and 10% dextrose prolotherapy (DPT). Comparative evidence between these interventions in OSD is limited. OBJECTIVES: To compare the 12-week clinical effectiveness of single PRP injection versus triple DPT injection series in adolescents with refractory OSD, specifically evaluating pain reduction (primary), functional improvement (primary), return-to-sports duration (secondary), and patient satisfaction (secondary). METHODS: This retrospective comparative cohort study included 40 adolescents with radiologically and clinically diagnosed refractory OSD treated between 2022 and 2024. Treatment allocation was non-randomized based on availability and patient preference. Patients received either a single PRP injection (n=20) or a triple DPT injection series (n=20). Primary outcomes were pain reduction (visual analog scale) and functional improvement (Lysholm Knee Score) measured at baseline, four, eight, and 12 weeks. Secondary outcomes included return-to-sports duration and patient satisfaction. Statistical analysis employed hierarchical Bonferroni correction for primary outcomes (adjusted α=0.0125) with secondary outcomes analyzed at α=0.05. RESULTS: PRP demonstrated greater pain reduction (VAS: 7.9±0.8 to 1.8±0.9 vs DPT: 7.6±1.0 to 3.4±1.1, p<0.001, Cohen's d=1.60, 95% CI: 1.15-2.05) and functional improvement (Lysholm: 50.8±6.2 to 91.5±4.8 vs 52.1±7.0 to 82.4±5.6, p<0.001, Cohen's d=1.71, 95% CI: 1.25-2.17). PRP patients returned to sports faster (6.1±1.2 vs 8.5±1.3 weeks, p<0.001, Cohen's d=1.94) with higher satisfaction rates (90% vs 65%, p=0.039, OR=5.54, 95% CI: 1.01-30.2). CONCLUSION: In this small retrospective study, PRP showed better short-term outcomes than DPT for refractory OSD, including greater pain reduction and faster return to sports. Further randomized controlled trials are warranted to confirm these findings.