Ankara Gaziler Phsycial Therapy and Rehabilitation Education and Research Hospital, University of Health Sciences, Ankara, Turkey.
Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy.
J Back Musculoskelet Rehabil. 2024;37(6):1455-1466. doi: 10.3233/BMR-240023.
Osteoarthritis (OA) is a widely-known disease distinguished by the breakdown of joint cartilage, leading to pain and morning stiffness. In this context, the role of corticosteroids is well known, but there is still a gap of knowledge on the duty of oxygen-ozone therapy (O2-O3).
To evaluate for effectiveness of ultrasound-guided O2-O3 injections compared with corticosteroid injections among patients diagnosed with knee OA.
This randomized controlled clinical trial was conducted on participants with knee OA who were randomly sorted into two groups: group A, undergoing corticosteroid group (n= 47) and group B, undergoing O2-O3 (n= 49) were injected within the knee joint under ultrasound guidance. The primary outcome measure was the change in the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score between baseline and 12-weeks post-injection. Secondary outcome measures included visual analog scale scores, joint effusion and a knee flexion ROM. Assessments were recorded at baseline and 4-weeks and 12-weeks post-injection. For the examination of intra- and inter-group variations at various time points, a repeated-measure analysis of variance (two-way ANOVA) was employed.
Ninety-six participants completed this study. Based on repeated measurement analysis of variance, a significant effect of time was found for all outcome measures in both groups. Both groups showed clinically significant improvements in knee pain, quality of life and, function. Baseline, 4-week post-injection and 12-week post-injection WOMAC scores (mean ± standard deviation) were 72.54 ± 18.89, 45,95 ± 13.30 and 37.10 ± 19.87 (p= 0.00, p= 0.00, p= 0.00; respectively) in the corticosteroid group, respectively and 68.23 ± 20.18, 42.99 ± 18.67, and 33.43 ± 18.24 (p= 0.00, p= 0.00, p= 0.00; respectively) in the ozone group, respectively. However, no significant group × time interaction was determined regarding all outcome measures.
The study demonstrates the efficacy of O2-O3 compared to steroid injections regarding functioning and pain relief among patients with diagnosed knee OA.
骨关节炎（OA）是一种广为人知的疾病，其特征是关节软骨的破裂，导致疼痛和晨僵。在这种情况下，皮质类固醇的作用是众所周知的，但关于臭氧治疗（O2-O3）的作用仍存在知识空白。
评估超声引导下 O2-O3 注射与皮质类固醇注射治疗膝骨关节炎患者的疗效。
这是一项随机对照临床试验，纳入了被诊断为膝骨关节炎的患者，并将他们随机分为两组：A 组，接受皮质类固醇注射（n=47），B 组，接受超声引导下膝关节内 O2-O3 注射（n=49）。主要结局指标为注射后 12 周时 Western Ontario 和 McMaster 大学骨关节炎（WOMAC）评分的变化。次要结局指标包括视觉模拟评分、关节积液和膝关节屈曲 ROM。在基线和注射后 4 周和 12 周时进行评估。为了检查不同时间点的组内和组间变化，采用重复测量方差分析（双向 ANOVA）。
96 名参与者完成了这项研究。基于重复测量方差分析，两组所有结局指标在时间上均有显著影响。两组患者的膝关节疼痛、生活质量和功能均有显著改善。皮质类固醇组的 WOMAC 评分在基线、注射后 4 周和 12 周时分别为 72.54±18.89、45.95±13.30 和 37.10±19.87（p=0.00、p=0.00、p=0.00；分别），臭氧组的 WOMAC 评分分别为 68.23±20.18、42.99±18.67 和 33.43±18.24（p=0.00、p=0.00、p=0.00；分别）。然而，在所有结局指标方面，均未确定组间×时间的交互作用。
本研究表明，与皮质类固醇注射相比，臭氧治疗在诊断为膝骨关节炎的患者中具有更好的疗效，可改善其功能和缓解疼痛。
