Oxygen–Ozone Therapy for the Treatment of Knee Osteoarthritis: A Systematic Review of Randomized Controlled Trials

Sconza, Cristiano; Respizzi, Stefano; Virelli, Lorenzo; Vandenbulcke, Filippo; Iacono, Francesco; Kon, Elizaveta; Matteo, Berardo Di

doi:10.1016/j.arthro.2019.05.043

Cited by 67 publications

(64 citation statements)

References 23 publications

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“…[12][13][14] Intra-articular O 2 O 3 injections are safe and have encouraging short-and medium-term effects on pain control and functional recovery in patients with KOA. 15,16 Injections of O 2 O 3 inhibit proinflammatory cytokines, such as prostaglandin E2, in favor of antiinflammatory cytokines, such as interleukin 10, transforming growth factor b, and interleukin 4; antioxidant enzymes; and angiogenesis. These components cooperate to repair the articular joint by stimulating fibroblasts, chondrocytes, and stem cells.…”

Section: Introductionmentioning

confidence: 99%

Integration of focal vibration and intra-articular oxygen–ozone therapy in rehabilitation of painful knee osteoarthritis

et al. 2021

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Objective To examine the pain-reducing effects of intra-articular oxygen–ozone (O2O3) injections and mechanical focal vibration (mFV) versus O2O3 injections alone in patients with knee osteoarthritis. Methods Patients with chronic pain (>6 weeks) due to knee osteoarthritis (II–III on the Kellgren–Lawrence scale) were consecutively enrolled and divided into two groups: O2O3 (n = 25) and O2O3-mFV (n = 24). The visual analog scale (VAS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Medical Research Council (MRC) Manual Muscle Testing scale were administered at baseline (before treatment), after 3 weeks of treatment, and 1 month after the end of treatment. Patients received three once-weekly intra-articular injections of O2O3 into the knee (20 mL O3, 20 μg/mL). The O2O3-mFV group also underwent nine sessions of mFV (three sessions per week). Results The VAS score, KOOS, and MRC score were significantly better in the O2O3-mFV than O2O3 group. The within-group analysis showed that all scores improved over time compared with baseline and were maintained even 1 month after treatment. No adverse events occurred. Conclusion An integrated rehabilitation protocol involving O2O3 injections and mFV for 3 weeks reduces pain, increases autonomy in daily life activities, and strengthens the quadriceps femoris.

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Section: Introductionmentioning

confidence: 99%

Integration of focal vibration and intra-articular oxygen–ozone therapy in rehabilitation of painful knee osteoarthritis

et al. 2021

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“…7. Oxygen-ozone, 11 which, due to its gaseous nature, could resemble the "smoke" of certain complex cocktails' preparation.…”

Section: See Related Article On Page 903mentioning

confidence: 99%

Editorial Commentary: Platelet-Rich Martini or Vodka Hyaluronate? The Dilemma of Drink Selection for the Modern Orthopaedic Surgeon

Matteo

Kon

2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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The number of options for intra-articular treatment of osteoarthritis has been growing over the years, and currently a wide range of injectables is available, from "traditional" products such as corticosteroids and hyaluronic acid (HA) to biologic agents like platelet-rich plasma (PRP) and mesenchymal stem cells. Although the ultimate goal is to exert a modulation on the intra-articular environment, these substances act through different mechanisms of action. The combination of different products may have a rationale in taking advantage of complementary actions, but the "additive" effect and the safety should be demonstrated before any recommendation of use. Recently, the combination of HA and PRP has been tested in some clinical trials, with outcomes apparently superior to those of HA and PRP alone. This strategy may open a new scenario for the future, provided that we put scientific evidence before the pressure of the market, especially when dealing with cell-based approaches, which, although very attractive for patients, still need solid data to support their use as injectables.

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“…We acknowledge that the field of nonsurgical approaches for the treatment of knee OA varies widely and is in constant evolution and new therapeutic options are emerging, such as polynucleotides, 16 bonemarrow derived MSCs, 17,18 and oxygen-ozone, whose role has been investigated in 11 RCTs to date, 19 and perhaps should have been included in the present study: in this regard, it is worth noting that only 2 RCTs (with 84 patients in total) on a-MSCs were included in the meta-analysis, thus showing the paucity of data on this novel technique, which limits the ability to compare it with other, more established treatments.…”

mentioning

confidence: 99%

Regarding “Intra-Articular Injections of Hyaluronic Acid or Steroid Associated With Better Outcomes Than Platelet-Rich Plasma, Adipose Mesenchymal Stromal Cell, or Placebo in Knee Osteoarthritis: A Network Meta-analysis”

Matteo

Delgado

Sánchez

et al. 2021

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Oxygen–Ozone Therapy for the Treatment of Knee Osteoarthritis: A Systematic Review of Randomized Controlled Trials

Cited by 67 publications

References 23 publications

Integration of focal vibration and intra-articular oxygen–ozone therapy in rehabilitation of painful knee osteoarthritis

Integration of focal vibration and intra-articular oxygen–ozone therapy in rehabilitation of painful knee osteoarthritis

Editorial Commentary: Platelet-Rich Martini or Vodka Hyaluronate? The Dilemma of Drink Selection for the Modern Orthopaedic Surgeon

Regarding “Intra-Articular Injections of Hyaluronic Acid or Steroid Associated With Better Outcomes Than Platelet-Rich Plasma, Adipose Mesenchymal Stromal Cell, or Placebo in Knee Osteoarthritis: A Network Meta-analysis”

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