Effect of intraarticular injection of ozone on inflammatory cytokines in knee osteoarthritis

Background: Knee Osteoarthrosis is one of the most debilitating diseases. Prolotherapy includes intra-articular injection of various drugs to decrease inflammation. Injection of intradiscal O2-O3 has reduced pain and disability in patients with low back pain due to prolapsed lumbar disk. To compare the effect of intraarticular injection of Ozone and steroids in improvement of clinical and cellular healing of knee osteoarthritis. Materials and Methods: in a randomized clinical trial, 70 patients with knee osteoarthrosis were included in the study. In Ozone group, 5 ml (35 μg/ml) of Ozone and in steroid group 5ml (50 mg) Triamcinolone was injected intra-articular. In 1, 2, and 6 months, patients were followed for pain scale, disability index and IL-1β and TNF-α serum levels were measured. Results: At 1 month after injection pain scale and disability index and IL-1β and TNF-α were decreased in both groups. However, at 2 and 6 month pain scale and disability index compared significantly lower in the Ozone group to steroid group (p<0.05). Besides, serum level of IL-1β and TNF-α compared also significantly lower at 2 and 6 months in the Ozone group in the steroid group (p<0.05). Conclusion: Intraarticular Ozone induces significantly longer improvement of pain and disability in knee osteoarthrosis compare to steroid injection. In addition, serum inflammatory cytokines are also lower in Ozone group compared to the steroid group along with clinical improvements.