Ozone Improves Pain, Function and Quality of Life in Patients with Knee Osteoarthritis: A Prospective Quasi-Experimental Before-After Study

Abstract

Background: The study was conducted to: 1) demonstrate the effectiveness of a treatment protocol with Ozone therapy in pain, function, and quality of life in patients with knee osteoarthritis; and 2) apply Ozone as a conservative treatment option with a demonstrable level of scientific evidence. Methods: This prospective quasi-experimental before-after study was conducted on 119 patients with knee osteoarthritis, having Kellgren-Lawrence grade 2 or more, who were referred to hospital of Santa Cristina's University, from January 2012 to April 2016. The protocol consisted of an intra-articular infiltration of a medical mixture of Oxygen-Ozone (95%-5%) 20mL, at a 20ug / mL concentration, during a total number of 4 sessions (once per week). Pain and quality of life were measured by visual analogical scale (VAS) and Western Ontarion and Mc Master Universities Index for osteoarthritis (WOMAC) at the beginning and end of the treatment. Results: The mean age of participants was 66.29 years. The sample was composed of 70.5% Women (n = 84) and 29.5% men (n = 35). The severity of OA according to Kellgren-Lawrence scale was 2.94°. Post-puncture erythema was 8.4% (n = 10). Pain measured by VAS significantly decreased (P < 0.0001) from the score 7.89 to 2.1. The scores of WOMAC-pain, WOMAC-stiffness, and WOMAC-function subscales decreased significantly (P < 0.0001) from 15.9 to 4.4, 3.5 to 0.9, and 49.5 to 17.6, respectively. The WOMAC total score decreased from 68.9 to 22.9 (P < 0.0001). Conclusions: Ozone is a safe medical treatment that can improve significantly pain relief, stiffness, and function in patients with knee osteoarthritis. The study shows a good level of evidence as well as a good grade of recommendation that allows us to consider Ozone as a conservative therapeutic option in the treatment of osteoarthritis of the knee.

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

“…In our case report, ozone (O2-O3) has been able to reduce pain and stiffness, in addition to improving function and quality of life, evidenced by an improvement in the clinical scales VAS (visual analog scale) and WOMAC (Western Ontario and McMaster University Index for Osteoarthritis), with a duration of effect of 6 months. These results agree with what was previously reported by our study group [8]. The symptomatic effect of ozone (O2-O3) on knee osteoarthritis is demonstrated in our clinical case and endorsed by the clinical study of Fernández-Cuadros et al [8].…”

“…These results agree with what was previously reported by our study group [8]. The symptomatic effect of ozone (O2-O3) on knee osteoarthritis is demonstrated in our clinical case and endorsed by the clinical study of Fernández-Cuadros et al [8].…”

“…Nowadays, there are no studies reported in the literature that demonstrate that ozone (O2-O3) has a structural effect on osteoarthritis of the knee [1,5], although it has proven its effect on the symptoms of osteoarthritis, whether pain or inflammation [6][7][8].…”

Ozone (O2 - O3) Has SYSADOA (Symptomatic Slow Acting Drug for Osteoarthritis) and DMDOA (Disease Modifying Drug for Osteoarthritis) Effect in Knee Osteoarthritis Patients

“…The arguments of this article are based on three previous quasi-experimental before-and-after studies published by the study group and with a level of evidence 2b (6,9,10). Scientists are encouraged to replicate the current promising findings for the management of knee OA.…”

“…The DMDOA effect may modify the natural history of knee OA and therefore delay knee arthroplasty replacement. The SYSADOA (6,8)…”