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

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. 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). 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. 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). 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.