Intra-articular ozone therapy efficiently attenuates pain in knee osteoarthritic subjects: A systematic review and meta-analysis

Noori-Zadeh, Ali; Bakhtiyari, Salar; Khooz, Roghayeh; Haghani, Karimeh; Darabi, Shahram

doi:10.1016/j.ctim.2018.11.023

Cited by 31 publications

(24 citation statements)

References 15 publications

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“…The use of intra-articular ozone (O2-O3) has proven to be a safe treatment, without adverse effects and capable of objectively improving clinical, laboratory, and radiological biomarkers, as it has been in the case of our patient with bilateral knee osteoarthritis. Therefore, we agree with Arias-Vazquez et al and Nori-Zadehh et al who, in two recent systematic reviews and meta-analyzes, believe that ozone (O2-O3) should be considered as a therapeutic alternative for the management of knee osteoarthritis [10,11].…”

Section: Discussionsupporting

confidence: 90%

Symptomatic (Pain and Inflammation) and Disease-Modifying Effect (Minimal Joint Space) of Intra-articular Ozone (O2-O3) in Osteoarthritis of the Knee: a Clinical Case

Fernández-Cuadros

Pérez-Moro

Albaladejo-Florín

et al. 2019

SN Compr. Clin. Med.

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The objective of the clinical case is to report the symptomatic effect and, for the first time, the disease-modifying effect of ozone in a patient with osteoarthritis of the knee. A 67-year-old woman has been infiltrated with ozone 1 time/week for 4 weeks, using an oxygen-ozone volume of 20 ml, at a 20-µg/ml concentration. Another cycle of ozone treatment was boosted at 6 months follow-up. Clinical outcomes such as pain, function, and quality of life were measured by the Western Ontario and McMaster University Index for Osteoarthritis (WOMAC) scale. Biochemical markers of inflammation such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and uric acid were performed at the beginning and at the end of ozone (O2-O3) treatment protocol. Radiological outcome was evaluated as the change in minimal joint space at the medial compartment of joint space, at the beginning and at 12 months follow-up in both knees. In the first and second ozone cycles, clinical (pain, function, rigidity) and biochemical variables (CRP, ESR, uric acid) improved in our case report. Minimal joint space at medial compartment improved in both knees after 12 months follow-up. Intra-articular ozone (O2-O3) has shown a symptomatic effect and especially a disease-modifying effect in a patient with knee osteoarthritis, improving pain, function, and rigidity; decreasing inflammation biomarkers (CRP, ESR, and uric acid); and increasing the joint space of the medial component evidenced radiologically. The structural effect is reported for the first time in literature. No adverse effects have been observed after intra-articular ozone infiltrations.

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Section: Discussionsupporting

confidence: 90%

Symptomatic (Pain and Inflammation) and Disease-Modifying Effect (Minimal Joint Space) of Intra-articular Ozone (O2-O3) in Osteoarthritis of the Knee: a Clinical Case

Fernández-Cuadros

Pérez-Moro

Albaladejo-Florín

et al. 2019

SN Compr. Clin. Med.

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“…Ozone therapy has been used to treat different conditions as summarized in Table 1, seen in different Randomized Clinical Trial (RCT) and reviewed by many authors. The conditions already studied includes: Tissue healing from inflammatory processes showed by a systematic review that included only RCT for chronic wounds (Fitzpatrick et al, 2018) and revised by Travagli et al (2010) and Valacchi et al (2005); for back pain revised by Braidy et al, 2018 and also showed by Andrade et al (2019) in a RCT; osteoarthritis showed in a systematic reviews (Anzolin and Bertol, 2018;Noori-Zadeh et al, 2019) and seeing in an RCT (Babaei-Ghazani et al, 2018; Lopes de Jesus et al, 2017) and in a clinical trial phase 2 (Calunga et al, 2012); diabetic foot ulcers as showed by a RCT (Zhang et al, 2014) and revised by others (Braidy et al, 2018); dental problems such as caries and periodontitis summarized in a review (Almaz and Sönmez, 2015); in the treatment of systemic sclerosis, as seeing in a RCT (Hassanien et al, 2018); multiple sclerosis, seeing in a clinical trial phase 1 (Delgado-Roche et al, 2017; Nowicka, 2017); among other conditions showed in clinical trials (Vanni et al, 2016). Increase in vessel numbers, collagen deposition and myofibroblasts numbers; Stimulation of the growth factors and peroxide releases; Improvement in oxygenation of the affected area.…”

Section: Ozone Clinical Usesmentioning

confidence: 99%

Clinical Uses and Molecular Aspects of Ozone Therapy: A Review

Pivotto¹,

Banhuk²,

Staffen³

et al. 2020

OnLine Journal of Biological Sciences

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Ozone was discovered over a hundred years ago and since then, it has been widely used in many areas, with the primary use as a disinfectant in various ways, but with applications in diverse conditions. More recently, the use of ozone has extended to other fronts, using it to treat different pathologies. Extensive studies have shown its effects, as well as the safety of its application in various modalities of use. Other studies showed its toxicity, which depends on the doses of use. Emerging evidence revealed that ozone also plays an important role in the wound healing and modulation of immune cells, describing the molecular pathways responsible for these actions and describing therapeutic actions in the treatment of wounds, pain, postoperative and infectious diseases. Ozone use has already been documented in different doses, forms of use and routes of application, depending on the clinical situation and an adaptation is necessary for a better result. Thus, this review summarizes the main clinical uses of ozone, presenting the molecular pathways responsible for its actions, as well as discussing the main routes of use, doses and, vehicles used in the clinic.

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“…According to the recommendation of WHO, the patients with BMI ≥25 Kg/m 2 were defined as overweight, and the patients with BMI ≥30 Kg/m 2 were defined as obese [4]. ere are many conservative treatments for OA, such as drug therapy, intra-articular injection of HA and PRP [5], physical therapy [6], and ozone therapy [7]. All kinds of treatments aim at relieving knee pain and improving joint mobility [8].…”

Section: Introductionmentioning

confidence: 99%

How to Choose Platelet-Rich Plasma or Hyaluronic Acid for the Treatment of Knee Osteoarthritis in Overweight or Obese Patients: A Meta-Analysis

Luo

Xiong

Sun

et al. 2020

Pain Research and Management

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Objective. The purpose of this meta-analysis was to determine whether platelet-rich plasma (PRP) was better than hyaluronic acid (HA) for the treatment of knee osteoarthritis (OA) in overweight or obese patients. Design. Two reviewers independently used the keywords combined with free words to search English-based electronic databases according to Cochrane Collaboration guidelines, such as PubMed, Embase, ScienceDirect, and Cochrane library. The pooled data were analyzed using RevMan 5.3. Results. Ten randomized controlled trials (RCTs) with 1096 patients were included. During the first two months of follow-up, there was no significant difference between the two groups. At the 3rd, 6th, and 12th months of follow-up, the pooled analysis showed that PRP was better than HA for the treatment of knee OA in overweight or obese patients. There were significant differences between the two groups at Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score (3 months: MD = −1.35, [95% CI: −2.19 to −0.50], P=0.002, I2 = 0%; 6 months: MD = −7.62, [95% CI: −13.51 to −1.72], P=0.01, I2 = 88%; 12 months: MD = −12.11, [95% CI: −20.21 to −4.01], P=0.003, I2 = 94%). Conclusions. For overweight or obese patients with knee OA, intra-articular injection of PRP in a short time was not necessarily superior to HA, but long-term use was better than HA in pain and functional relief.

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Intra-articular ozone therapy efficiently attenuates pain in knee osteoarthritic subjects: A systematic review and meta-analysis

Cited by 31 publications

References 15 publications

Symptomatic (Pain and Inflammation) and Disease-Modifying Effect (Minimal Joint Space) of Intra-articular Ozone (O2-O3) in Osteoarthritis of the Knee: a Clinical Case

Symptomatic (Pain and Inflammation) and Disease-Modifying Effect (Minimal Joint Space) of Intra-articular Ozone (O2-O3) in Osteoarthritis of the Knee: a Clinical Case

Clinical Uses and Molecular Aspects of Ozone Therapy: A Review

How to Choose Platelet-Rich Plasma or Hyaluronic Acid for the Treatment of Knee Osteoarthritis in Overweight or Obese Patients: A Meta-Analysis

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