ozone decreases biomarkers of inflamation (c-reactive protein and erytrocyte sedimentation rate) and improves pain, function and quality of life in knee osteoarthrtitis patients: a before-and-after study and review of the literature

Objectives: the aim of this study was to evaluate if ozone is capable of decreasing biomarkers of inflammation (crp/esr) and pain, and to improve function and quality of life in knee osteoarthrtitis (oa) patients. methods: a prospective quasi experimental (before-and-after study) research was performed to investigate the effect of ozone therapy protocol. the intervention included 4 sessions (1 session/week) of an intra-articular infiltration of a medical mixture of oxygen- ozone (95% to 5%) at 20 ug/ml concentration. biochemical evaluation (crp and esr), pain vas, and womac scales were evaluated before and after the treatment. results: overall, 33 patients were evaluated. mean age was 68.18 ± 8.43 years. female patients accounted for 75.7% (n = 25) and male patients corresponded to 24.3% (n = 8). female: male ratio was 3:1. the most frequent radiological kl grade was 2º (n = 22, 66.7%), followed by 3º (n = 8, 24.2%), and 4º (n = 3, 9.1%). biomarkers of inflammation decreased significantly. c-reactive protein (crp) diminished from 0.33 ± 0.32 mg/dl to 0.25 ± 0.23 mg/dl (p = 0.0456). erythrocyte sedimentation rate (esr) decreased from 15.06 ± 12.09 mm/h to 11.81 ± 8.32 mm/h (p = 0.01). before treatment, pain measured by vas was 7.33 ± 1.31 points and decreased to 2.84 ± 1.76 (p < 0.0001). the womac-pain subscale was 14.84 ± 2.77 points and diminished to 5.96 ± 3.53 (p < 0.0001), womac stiffness subscale was 3.06 ± 1.95 points and ameliorated to 1.15 ± 1.3 (p < 0.0001), womac-function subscale was 41.15 ± 12.58 points and decreased to 22.3 ± 11.64 (p < 0.0001). conclusions: ozone is capable of both decreasing pain and stiffness and improving function and quality of life in knee oa patients, yet decreases biomarkers of inflammation, such as crp and esr.