AB1246-HPR Intra articular ozone or hyaluronic acid injection: which one is superior in patients with knee osteoarthritis? a 6-month randomized clinical trial
Authors: SA Raeissadat, SM Rayegani, M Moridnia, S Rahimi Dehgolan
Journal: Annals of the Rheumatic Diseases (2017)

<h3>Background</h3> Knee osteoarthritis (OA) is a common disease with great burden through pain and decreased function (1). Except for knee replacement surgery as a definite treatment (2), there are many other therapeutic modalities including non-pharmacologic choices and some heterogeneous drugs like oral, topical and intra articular ones (3). Recent studies have showed promising results of ozone application in OA (2,4–5). <h3>Objectives</h3> The aim of this study was to compare the effects of ozone therapy versus hyaluronic acid (HA) intra articular injection in patients with knee OA. <h3>Methods</h3> This prospective RCT studied 174 patients in two random groups: ozone and HA. We performed three weekly injections of Hyalgan® versus 10 ml of ozone solution in moderate knee OA patients. Participants were primarily evaluated and 6 months after injection using pain, stiffness and function questionnaires. <h3>Results</h3> No major adverse events were noted in the study. Total WOMAC score decreased in the ozone group from 40.8±9.8 to 20.4±4.9 (p&lt;0.05) and in the HA group from 38.5±7.9 to 17.1±4.2 (p&lt;0.05). A similar trend was observed in pain improvement according to VAS (table 1). Pain, stiffness and function significantly improved in both groups but no differences were found between groups. <h3>Conclusions</h3> Although both ozone and HA can be effectively used for improving function and reducing pain in selected patients with knee OA, neither of the two showed no superiority at 6 months follow up. <h3>References</h3> Richmond J, Hunter D, Irrgang J, et al. American Academy of Orthopaedic Surgeons clinical practice guideline on the treatment of osteoarthritis (OA) of the knee. J Bone Joint Surg Am 2010; 92:990–993. Kr Mishra S, Pramanik R, Das P, Pratim Das Pl. Role of intra-articular ozone in osteoarthritic knee for functional and symptomatic improvement. IJPMR 2011;22:65–69. Bellamy N, Campbell J, Robinson V, Gee T, Bourne R, Wells G. Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev 2006;(2):CD005321. Sello Lebohang Manoto, Makwese Johaness Maepa, Shirley Keolebogile Motaung. Medical ozone therapy as a potential treatment modality for regeneration of damaged articular cartilage in osteoarthritis [Article in Press]. Saudi Journal of Biological Sciences (2016). Velio Alvaro Bocci. Scientific and Medical Aspects of Ozone Therapy: State of the Art. Archives of Medical Research 37 (2006) 425–435. <h3>Disclosure of Interest</h3> S. A. Raeissadat Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, S. M. Rayegani Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, M. Moridnia Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None, S. Rahimi Dehgolan Shareholder of: None, Grant/research support from: None, Consultant for: None, Employee of: None, Paid instructor for: None, Speakers bureau: None