Background Knee osteoarthritis (OA) is a common disease with great burden through pain and decreased function (1). Except for knee replacement surgery as a definite treatment (2), there are many other therapeutic modalities including non-pharmacologic choices and some heterogeneous drugs like oral, topical and intra articular ones (3). Recent studies have showed promising results of ozone application in OA (2,4–5).

Objectives The aim of this study was to compare the effects of ozone therapy versus hyaluronic acid (HA) intra articular injection in patients with knee OA.

Methods This prospective RCT studied 174 patients in two random groups: ozone and HA. We performed three weekly injections of Hyalgan® versus 10 ml of ozone solution in moderate knee OA patients. Participants were primarily evaluated and 6 months after injection using pain, stiffness and function questionnaires.

Results No major adverse events were noted in the study. Total WOMAC score decreased in the ozone group from 40.8±9.8 to 20.4±4.9 (p<0.05) and in the HA group from 38.5±7.9 to 17.1±4.2 (p<0.05). A similar trend was observed in pain improvement according to VAS (table 1). Pain, stiffness and function significantly improved in both groups but no differences were found between groups.

Conclusions Although both ozone and HA can be effectively used for improving function and reducing pain in selected patients with knee OA, neither of the two showed no superiority at 6 months follow up.

References

1. Richmond J, Hunter D, Irrgang J, et al. American Academy of Orthopaedic Surgeons clinical practice guideline on the treatment of osteoarthritis (OA) of the knee. J Bone Joint Surg Am 2010; 92:990–993.

2. Kr Mishra S, Pramanik R, Das P, Pratim Das Pl. Role of intra-articular ozone in osteoarthritic knee for functional and symptomatic improvement. IJPMR 2011;22:65–69.

3. Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G. Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev 2006;(2):CD005321.

4. Sello Lebohang Manoto, Makwese Johaness Maepa, Shirley Keolebogile Motaung. Medical ozone therapy as a potential treatment modality for regeneration of damaged articular cartilage in osteoarthritis [Article in Press]. Saudi Journal of Biological Sciences (2016).

5. Velio Alvaro Bocci. Scientific and Medical Aspects of Ozone Therapy: State of the Art. Archives of Medical Research 37 (2006) 425–435.

References

Disclosure of Interest S. A. Raeissadat Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, S. M. Rayegani Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, M. Moridnia Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, S. Rahimi Dehgolan Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None