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

C. Sconza, S. Respizzi, L. Virelli, F. Vandenbulcke, F. Iacono, E. Kon, B. Di Matteo

Arthroscopy: The Journal of Arthroscopy And Related, 2019

858 participants · 87 citations

Abstract

PURPOSE

To review the available literature on the application of oxygen-ozone therapy (OOT) in the treatment of knee osteoarthritis (KOA) to understand its therapeutic potential and to compare it with other conservative treatment options.

METHODS

A systematic review of the literature was performed on the PubMed, Cochrane, Embase, ResearchGate, and PedRo Databases, with the following inclusion criteria: (1) randomized controlled trials (RCTs), (2) written in English, (3) published on indexed journals in the last 20 years (1998-2018), (4) dealing with the use of ozone intra-articular injection for the treatment of KOA. The risk of bias was assessed by the Cochrane Risk of Bias tool for RCTs.

RESULTS

Eleven studies involving 858 patients in total (629 female and 229 male) were included. Patients in the control groups received different treatments: placebo in 1 trial; hyaluronic acid in 2 studies; hyaluronic acid and PRP in 1 trial; corticosteroids in 4; and hypertonic dextrose, radiofrequency, or celecoxib + glucosamine in the remaining 3 trials. In looking at the quality of the available literature, we found that none of the studies included reached "good quality" standard, 2 were ranked as "fair," and the rest were considered "poor." No major complications or serious adverse events were reported following intra-articular OOT, which provided encouraging pain relief at short term. On the basis of the available data, no clear indication emerged from the comparison of OOT with…

How strong is the evidence?

Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 858 participants or records.

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