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

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

11 randomized trials of intra-articular oxygen-ozone in knee osteoarthritis published between 1998 and 2018, 858 patients, with control arms spread across placebo in 1 trial, hyaluronic acid in 2, hyaluronic acid with PRP in 1, corticosteroids in 4, and hypertonic dextrose, radiofrequency or celecoxib with glucosamine in the remaining 3. The review's central finding is about the evidence rather than the treatment: none of the 11 trials reached the reviewers' standard for good quality, 2 were rated fair and the rest poor. No major complications or serious adverse events followed intra-articular ozone in any trial, and the reviewers describe short-term pain relief as encouraging. They report that no clear indication emerged from comparing ozone with the other established treatments.

Population

11 randomized controlled trials of intra-articular ozone for knee osteoarthritis published 1998-2018, 858 patients

Intervention

Intra-articular oxygen-ozone therapy

Comparator

Placebo in 1 trial, hyaluronic acid in 2, hyaluronic acid and PRP in 1, corticosteroids in 4, and hypertonic dextrose, radiofrequency or celecoxib with glucosamine in the remaining 3

Limitations

Read from the abstract only: the publisher answers HTTP 403 to every route this project has, so the quality ratings and the trial-by-trial detail have not been checked against the paper. The review is a narrative synthesis with no pooling, so no effect size comes out of it. Its search stopped in 2018 and it is restricted to English-language publications. Needs a library pull.