Could Ozone Be Used as a Feasible Future Treatment in Osteoarthritis of the Knee?

Abstract

Osteoarthritis (OA) is one of the most disabling and incapacitating diseases on the autonomy of older people, affecting their quality of life. OA produces great impact on pain, function and use of resources, being considered as an important problem of Public Health. OA is a degenerative and progressive disease without treatment nowadays. The goals in OA treatment are to ameliorate symptoms and diminish articular damage. In knee OA, there is destruction of cartilage and subchondral bone, with the consequent narrowing of articular space. Knee OA is multifactorial. Besides the bio mechanic factors, trauma and obesity; it is believed that inflammation plays an important role. Future treatments should act on the regulation of inflammation to diminish progression of OA. There is evidence on several studies and years of experience that state that Ozone acts on the modulation of inflammation. The objective of this paper is to review the main pathophysiological mechanisms involved in knee OA, and to postulate ozone as a promising and ideal conservative treatment, since it could act on several therapeutic targets, besides inflammation.

Efficiency of Platelet-rich Plasma (PRP) Compared to Ozone Infiltrations on Patellofemoral Pain Syndrome and Chondromalacia: A Non- Randomized Parallel Controlled Trial

“…PRP releases growth factors and cytokines that reduce inflammation, and stimulate cartilage regeneration [41]. Ozone could act on inflammation, modulate it and act on many other targets such as growth factors, stem cells, inflammatory cytokines, all of them could stimulate chondrocyte growth and cartilage repair [24]. All these reasons made us postulate PRP and Ozone as alternative promising options in the management of anterior knee pain secondary to PFPS or Chondromalacia, and issue that has been confirmed by our present study.…”

“…All these cytokines produce cartilage destruction [24]. In the case of PRP treatment, PRP delivers high concentration of growth factors (TGF-β, ILGF, PDGF, BFGF, EGF, VEGF) and bioactive proteins; all of them stimulate angiogenesis and stem cells, inhibit inflammation and catabolic enzymes/cytokines, in order to repair cartilage injuries [44].…”

“…In the case of PRP treatment, PRP delivers high concentration of growth factors (TGF-β, ILGF, PDGF, BFGF, EGF, VEGF) and bioactive proteins; all of them stimulate angiogenesis and stem cells, inhibit inflammation and catabolic enzymes/cytokines, in order to repair cartilage injuries [44]. In the case of Ozone, Fernández-Cuadros have recently stated that Ozone acts on several targets that are implicated in the degradation cartilage and bone [24]. Specifically, Ozone inhibits MMP, NO synthesis, PGE 2 , IL-1, TNF-α, IFN-Υ, IFN-β; Ozone stimulates IL-4, IL-6.…”

“…Specifically, Ozone inhibits MMP, NO synthesis, PGE 2 , IL-1, TNF-α, IFN-Υ, IFN-β; Ozone stimulates IL-4, IL-6. IL-10, IL-13, TGF-β, IGF-1, stem cells and chondrocytes [24]. All these assumptions made us considerer both treatment options as available for the management of anterior knee pain secondary to PFPS or Chondromalacia.…”

“…In fact, Kon et al [23] have stated promising outcomes from intra articular PRP in early degenerative cartilage lesions, a common feature of Chondromalacia. On the other hand, Fernández-Cuadros [24,25] stated that inflammation, a common feature of Chondromalacia, pain and poor function could be reverted by Ozone treatment, if infiltrated intra articularly. Therefore, despite the paucity of studies on Ozone treatment, and the growing studies on PRP treatments, to the best of our knowledge, there is no report that compares PRP to Ozone infiltrations in the management of PFPS and Chondromalacia.…”