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