The effects of oxygen-ozone therapy in knee osteoarthritis: A systematic review

Farì G, Fai A, Donati D, Tedeschi R, Varrassi G, Ricci V, Sconza C, Baricich A, Bernetti A · Journal of Back and Musculoskeletal Rehabilitation

A narrative synthesis of 5 randomized trials of oxygen-ozone therapy in knee osteoarthritis, with corticosteroid, hyaluronic acid and placebo among the comparators. The authors report reduced pain and improved joint mobility, some trials showing longer-lasting effects than corticosteroid, and reductions in pro-inflammatory cytokines. They describe the treatment as minimally invasive with fewer side effects than the alternatives, and name treatment variability and absent long-term follow-up as the limits on what they can conclude.

Population

5 randomized controlled trials of oxygen-ozone therapy in knee osteoarthritis

Intervention

Intra-articular oxygen-ozone therapy

Comparator

Corticosteroids, hyaluronic acid and placebo

Limitations

Written from the abstract, so neither the five trials nor the cytokine claim has been checked against the paper. Five trials is the smallest base of any of these syntheses, nothing is pooled, and no effect size is reported. The claim that ozone modifies disease mechanisms rests on cytokine measurements rather than on any structural endpoint.