Efficacy of combined ozone and platelet-rich-plasma treatment versus platelet-rich-plasma treatment alone in early stage knee osteoarthritis

J Back Musculoskelet Rehabil. 2019;32(2):305-311. doi: 10.3233/BMR-181301.

Abstract

Background: Osteoarthritis (OA) is a chronic disease most often occurring in knee joints, leading to pain of varying severity and deterioration in daily living activities.

Objective: To compare efficacy of platelet-rich-plasma (PRP) versus PRP in combination with ozone gas injection in patients with early stage knee OA.

Methods: Retrospective data of patients who received PRP alone (n= 45) or combined treatment (PRP + ozone, n= 35) injection was analyzed. Patients were evaluated using the visual analogue scale (VAS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores.

Results: In both PRP alone and combined treatment groups, post-treatment VAS and WOMAC scores at month 1, month 3, and month 6 showed a significant reduction compared to pre-treatment scores (p< 0.001). Physical function and total WOMAC scores as well as VAS scores at post-treatment month 3 were significantly lower in the combined treatment group compared to the PRP alone group. Moreover, in the combined treatment group, VAS scores on Day 10 and hyper-inflammation at the injection site was significantly lower than the PRP alone group.

Conclusion: In general, similar efficacy was observed between treatment with PRP alone and treatment with PRP in combination with ozone. However, patients receiving ozone treatment are less likely to experience post-injection pain and are more likely to recover faster when compared to patients receiving PRP treatment alone.

Keywords: Platelet-rich-plasma; knee; osteoarthritis; ozone.

Publication types

  • Comparative Study

MeSH terms

  • Activities of Daily Living
  • Aged
  • Combined Modality Therapy
  • Female
  • Humans
  • Inflammation / etiology
  • Injections, Intra-Articular / adverse effects
  • Knee Joint / physiopathology
  • Male
  • Middle Aged
  • Osteoarthritis, Knee / therapy*
  • Oxidants, Photochemical / therapeutic use*
  • Ozone / therapeutic use*
  • Pain
  • Pain Measurement
  • Platelet-Rich Plasma*
  • Recovery of Function
  • Retrospective Studies
  • Treatment Outcome
  • Visual Analog Scale

Substances

  • Oxidants, Photochemical
  • Ozone