Intra-articular ozone infiltrations have been used as a therapeutic intervention in osteoarthritis of the knee with reports of favourable effects. However, this therapeutic procedure is still controversial due to the lack of scientific evidence to justify its use.
To evaluate the safety and efficacy of intra-articular ozone infiltrations in patients with knee osteoarthritis.
A systematic search was performed in electronic databases such as Pubmed, Dialnet, Scielo, Medigraphic and other electronic sources from January 1990 to January 2018. We included controlled clinical trials that used intra-articular ozone infiltrations as a therapeutic intervention in patients with knee osteoarthritis. The variables analysed were the study design, risk of bias, clinical configuration, characteristics of the participants, characteristics of the interventions, results, length of follow-up and adverse events.
Ten studies with a total of 400 patients treated with ozone vs 381 controls were included in the systematic review. Most studies had a high risk of bias. Intra-articular ozone infiltrations were more effective than placebo and were as effective as other interventional treatments in short-term follow-up. No adverse effects or serious adverse reactions were reported in the treated patients.
Intra-articular ozone infiltration appears to be an effective therapeutic intervention in the short term. However studies with better methodological quality are needed to confirm its efficacy and to analyze long-term safety.