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Musculoskeletal and Sports Medicine

Session: Efficacy of hyperosmolar dextrose injection for Osgood-Schlatter disease: a systematic review with meta-analysis

Efficacy of Hyperosmolar Dextrose Injection for Osgood-Schlatter Disease: A Systematic Review with Meta-Analysis

Saturday, October 25, 2025
12:00 PM - 1:30 PM MT
Location: Kiosk 8

    Poster Presenter(s)

  • Lori Bjork, MD

    Resident
    Mayo Clinic College of Medicine & Science (Rochester) PM&R Program
    Rochester, Minnesota

    • Co-Author(s)

  • HR

    Hye Chang Rhim, MD

    Sports Medicine Fellow
    Spaulding Rehabilitation Hospital/Harvard Medical School PM&R Program
    Charlestown, Massachusetts

  • Jaehyung Shin, BS

    Undergraduate Student (Graduated)
    Georgia Institute of Technology
    Corona, California

  • JP

    Jewel Park, MD, MPH

    Physician postgraduate
    Los Angeles General Medical Center/University of Southern California
    Los Angeles, California

  • SD

    Stephanie DeLuca, MD

    Clinical Instructor of Physical Med and Rehabilitation
    MassGeneral Brigham/Spaulding Rehabilitation/Harvard Medical School PM&R Program
    Newton, Massachusetts

  • KM

    Katelyn McCarron, Other

    Researcher
    Mass General Brigham
    Carver, Massachusetts

  • Chris Ha, DO

    Senior Associate Consultant
    Mayo Clinic Arizona
    Scottsdale, Arizona

Disclosure(s):
Lori Bjork, MD: No financial relationships to disclose
Jaehyung Shin, BS: No financial relationships to disclose
Stephanie DeLuca, MD: No financial relationships to disclose
Chris Ha, DO: No financial relationships to disclose
Background and/or Objectives: Osgood-Schlatter disease (OSD) is a common cause of anterior knee pain in adolescents. Patients may have refractory symptoms despite conventional management including activity modification, physical therapy, ice, and NSAIDs. This systematic review aimed to evaluate the efficacy of hyperosmolar dextrose injection in OSD which can be a potential adjunct treatment.

Design: Systematic review and meta-analysis

Setting : Outpatient clinics

Participants : A total of 166 patients (162 males and 4 females) with 184 knees

Interventions: Hyperosmolar dextrose injection compared to placebo injection including lidocaine and/or saline

Main Outcome Measures: Nirschl Pain Phase Scale (NPPS), Victorian Institute of Sport Assessment (VISA), pain-free return to sport, and adverse events.

Results: A total of 3 randomized controlled trials (RCTs) and 1 case series were identified from a librarian-assisted search performed in 8 databases. A meta-analysis demonstrated that there was no significant difference in patient-reported improvement from baseline between treatment and placebo groups at 3 months (SMD=1.92, 95% confidence interval [CI], -0.12 to 3.96; I² =96.2%). However, at 1 year, a meta-analysis showed greater patient-reported improvement from baseline with treatment compared to placebo (SMD=1.09, 95% CI, 0.62 to 1.56; I²= 0%). Additionally, when evaluating for pain-free return to sports at 3 months, a meta-analysis demonstrated a pooled risk ratio of 2.11 (95% CI: 1.12 to 3.98, I²=30.73%) indicating that patients receiving hyperosmolar injection therapy were 2.11 times more likely to become pain-free during sports at 3 months compared to the control group.

Conclusions: Based on the limited number of RCTs, hyperosmolar dextrose injection may help facilitate a pain-free return to sports at 3 months and lead to patient-reported improvement at 1 year. However, further high-quality RCTs would be necessary to confirm these findings.