Short term therapeutic effects of ozone in the management of pain in knee osteoarthritis: A Meta-analysis.
PM R. 2019 Jan 28. Epub 2019 Jan 28. PMID: 30689297
Pedro Iván Arias-Vázquez
BACKGROUND: Ozone therapy has been widely used to decrease pain related to osteoarthritis, but the effectiveness of this treatment has not been evaluated.
OBJECTIVE: To evaluate the effectiveness of ozone therapy in the reduction of pain in patients with knee OA, according to the type of intervention and duration of the effect. TYPE: Meta-analysis LITERATURE SURVEY: We performed an online search using PUBMED, DIALNET, SCIELO, MEDIGRAPHIC and ISCO3 databases. We searched for articles published up to January 2018.
PARTICIPANTS: We selected eight studies including a total of 355 patients and 363 controls.
METHODOLOGY: Only randomized controlled trials that assessed the efficacy of intra-articular or peri-articular infiltrations with ozone to treat knee osteoarthritis in humans were included in the analysis. The results are expressed as standardized mean difference and 95% CI. The meta-analysis was performed in accordance with the statement of Preferment Reporting Items for Systematic Reviews and Meta-Analyses.
SYNTHESIS: Therapeutic effects were compared between ozone treatment and placebo (d=-0.81, IC 95% -1.06 to -0.55, I=34.79 p(Q)=.47) or other non-invasive treatments. No significant effects were found in favor of the ozone treatment when compared with the use of hyaluronic acid or platelet-rich plasma. However, the use of ozone had a significant short-term benefit reducing knee pain (d=-2.26, IC95% -2.26 a -3.72, I=97, p(Q)<.001). Pain relief benefits lasted between 3-6 months.
CONCLUSION: Our results indicate that intra-articular infiltrations of ozone can be used as an optional effective treatment for the management of pain related to knee osteoarthritis. There are short term effect benefits that peak at around one month of treatment, with a gradual decline in efficacy after 3-6 months of treatment. More studies are needed to improve our understanding the efficacy of this interventional treatment. This article is protected by copyright. All rights reserved.