Intra-articular injections of ozone versus hyaluronic acid for knee osteoarthritis: a level I meta-analysis.

Autor: Migliorini F; Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), 39100, Bolzano, Italy.; Department of Life Sciences, Health, and Health Professions, Link Campus University, 00165, Rome, Italy.; Department of Orthopaedic and Trauma Surgery, Eifelklinik St.Brigida, 52152, Simmerath, Germany., Giorgino R; Residency Program in Orthopedics and Traumatology, University of Milan, Milan, Italy., Mazzoleni MG; Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), 39100, Bolzano, Italy., Schäfer L; Department of Orthopaedic and Trauma Surgery, Eifelklinik St.Brigida, 52152, Simmerath, Germany., Bertini FA; Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), 39100, Bolzano, Italy., Maffulli N; Department of Trauma and Orthopaedic Surgery, Faculty of Medicine and Psychology, University La Sapienza, 00185, Rome, Italy. nicola.maffulli@uniroma1.it.; School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Stoke On Trent, ST4 7QB, UK. nicola.maffulli@uniroma1.it.; Centre for Sports and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Mile End Hospital, Queen Mary University of London, London, E1 4DG, UK. nicola.maffulli@uniroma1.it.
Jazyk: angličtina
Zdroj: European journal of orthopaedic surgery & traumatology : orthopedie traumatologie [Eur J Orthop Surg Traumatol] 2024 Nov 23; Vol. 35 (1), pp. 20. Date of Electronic Publication: 2024 Nov 23.
DOI: 10.1007/s00590-024-04135-x
Abstrakt: Introduction: Intra-articular injections of ozone and hyaluronic acid (HA) are routinely performed for the management of knee osteoarthritis. The present meta-analysis compared intra-articular injections of HA versus ozone in patients with knee osteoarthritis (OA) in patient-reported outcome measures (PROMs). The outcomes of interest were to determine if intra-articular ozone injections show comparable visual analogue scale (VAS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) scores compared to intra-articular HA injections.
Methods: This study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the 2020 PRISMA statement. In January 2024, the following databases were accessed: PubMed, Web of Science, Google Scholar, and Embase. All the randomised controlled trials (RCTs) comparing intra-articular HA versus ozone injections in patients with knee OA were accessed. Only studies which clearly stated that injections were performed in patients with knee OA were considered. Data concerning the VAS and WOMAC were retrieved at baseline and the last follow-up. Studies with a follow-up shorter than 4 months or longer than 6 months were not included.
Results: Data from 424 patients were collected. 74% (314 of 424 patients) were women. The mean age of the patients was 61.1 ± 4.5 years, and the mean BMI was 27.8 ± 0.8 kg/m 2 . Compatibility was found in the mean age, mean BMI, PROMs, and the percentage of women. No difference was found in VAS at follow-up (P = 0.4).
Conclusion: The current level I evidence suggests that ozone and HA intra-articular injections achieve similar pain control between 4 and 6 months of follow-up.
Level of Evidence: Level I.
Competing Interests: Declarations. Conflict of interest: The authors declare that they have any competing interests for this article. Ethical approval: This study complies with ethical standards. Consent to participate: Not applicable. Consent to publish: Not applicable. Registration and protocol: The present review was not registered.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)
Databáze: MEDLINE
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