Therapeutic Efficacy of Ozone Injection into the Knee for the Osteoarthritis Patient along with Oral Celecoxib and Glucosamine

Abstract

Introduction: Suffering from osteoarthritis is prevalent among elderly patients so the use of intra-articular injection of medical ozone may well be the effective way to relieve their pain. Aim:To evaluate the effect of intra-articular injection of medical ozone given into the knee of the osteoarthritis patients, and to compare it with taking celecoxib and glucosamine orally. Materials and Methods:In the present study, 76 patients suffering from osteoarthritis were randomly assigned into two groups. In the ozone group, 20 ml ozone-oxygen mixture gas concentration of 20 μg/ml was injected into knee articular cavity and each patient took oral celecoxib and glucosamine hydrochloride. Patients in control group only took the celecoxib and glucosamine hydrochloride orally.Pain score and Lysholm knee score were measured prior to the injection (pretreatment) and at one, three, six weeks after the beginning of the treatment (posttreatment).Results: After the treatment, the pain intensity and function significantly improved in the two groups compared with the pretreatment (p<0.05). In the ozone group, three weeks after intervention, the pain score improved significantly when compared with the control group (p<0.05).After the treatment, the lysholm scores increased significantly (p<0.05), but in the ozone group, it improved faster. Conclusion:Intra-articular injection of ozone plus oral celecoxib and glucosamine could significantly decrease pain intensity in patients with mild to moderate Knee Osteoarthritis (KOA), and improve their functional status early than oral celecoxib and glucosamine only.

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

“…A detailed description of each study has been provided in Table 1. 8,[13][14][15][16][17][18][19][20][21][22] Study Design and Quality All studies were, as per inclusion criteria, RCTs. The study designs were highly variable: patients in the control groups received different injection or treatment, such as HA in 3 studies; corticosteroids in 4 studies; and placebo, hypertonic dextrose, radiofrequency, or celecoxib þ glucosamine in the remaining 4 studies.…”

“…All papers except one 15 performed a radiographic assessment before treatment and classified patients according to Kellgren-Lawrence (K-L) grading system. Five papers included patients with radiographic K-L grades II-III, 13,16,17,19,20 4 papers included patients with radiographic K-L grades I-II, 8,18,21,22 whereas Babaei-Ghazani et al 14…”

“…In contrast, Hashemi et al 8 showed no significant difference neither between O 3 and hypertonic dextrose injection nor between O 3 and radiofrequency (with the exception of patients older than 65 years). 16 In Feng and Beiping's trial, 22 results were controversial: pain improved significantly more in the O 3 þ celecoxib group than in the celecoxib group only at 3 weeks' follow-up. The paper by Chansoria et al 21 also presented controversial findings, because O 3 was injected both in the treatment and control group (with or without concurrent intra-articular steroids).…”

Short‐Term Therapeutic Effects of Ozone in the Management of Pain in Knee Osteoarthritis: A Meta‐Analysis

“…Ninety‐three eligible articles were identified, after excluding overlapped abstracts between the databases; 53 abstracts were retrieved for detailed evaluation. Fourteen randomized‐controlled trials remained for analysis after removing 39 unsuitable articles. Finally, only eight studies were chosen for having the necessary data to be included in the meta‐analysis (Figure ).…”

“…Fourteen randomized-controlled trials 13,18-20,22-31 remained for analysis after removing 39 unsuitable articles. Finally, only eight studies were chosen for having the necessary data to be included in the meta-analysis 13,19,20,24,26,[29][30][31] (Figure 2).…”