Short‐Term Therapeutic Effects of Ozone in the Management of Pain in Knee Osteoarthritis: A Meta‐Analysis

Background Ozone therapy has been used widely to decrease pain related to osteoarthritis, but the effectiveness of this treatment has not been evaluated. Objective To evaluate the effectiveness of ozone therapy in the reduction of pain in patients with knee osteoarthritis, according to the type of intervention and duration of the effect. Type Meta‐analysis. Literature Survey We performed an online search using PUBMED, DIALNET, SCIELO, MEDIGRAPHIC, and ISCO3 databases. We searched for articles published up to January 2018. Participants We selected eight studies including a total of 355 patients and 363 controls. Methodology Only randomized‐controlled trials that assessed the efficacy of intraarticular or periarticular infiltrations with ozone to treat knee osteoarthritis in humans were included in the analysis. The results are expressed as standardized mean difference and 95% confidence intervals. The meta‐analysis was performed in accordance with the statement of Preferred Reporting Items for Systematic Reviews and Meta‐Analyses. Synthesis We observed that ozone treatment had a therapeutic effect when compared with placebo (d = −0.81, 95% CI −1.06 to −0.55, I2 = 34.79, P(Q) = .47) or other noninvasive treatments. No significant effects were found in favor of the ozone treatment when compared with the use of hyaluronic acid or platelet‐rich plasma. However, the use of ozone had a significant short‐term benefit reducing knee pain (d = −2.26, 95% CI −2.26 to −3.72, I2 = 97, P(Q)