Year 2020 / Volume 27 / Number 2

Original

Intra-articular ozone modulates inflammation, ameliorates pain and stiffness, improves function and has anabolic effect on knee osteoarthritis: a prospective quasiexperimental before-and-after study, 115 patients

Rev. Soc. Esp. Dolor. 2020; 27(2): 78-88 / DOI: 10.20986/resed.2020.3775/2019

Marcos Edgar Fernández-Cuadros, Olga Susana Pérez-Moro, María Jesús Albaladejo-Florin, Sandra Álava


ABSTRACT

Purpose: The objective of the present study is to verify for the first time in the literature the symptomatic and modifying disease effect of ozone (O2-O3) through clinical (pain, function and stiffness), biochemical (C-reactive protein [CRP], erythrocyte sedimentation rate [ESR], uric acid) and radiological improvement (minimum medial and lateral joint space) in a series of patients with osteoarthritis of the knee.
Methods: A prospective quasi-experimental beforeand-after study was performed in 115 patients with knee osteoarthritis Kellgren-Lawrence grade 2 or more. The ozone protocol consisted of 4 sessions (one session / week) of an intra-articular injection of 20 ml of a medical mixture of Oxygen-Ozone (95-5ºC) at a concentration of 20 μg / ml. Outcome variables included clinical (pain, stiffness, and function), biochemical (CRP, ESR, uric acid), and radiological variables (minimal femorotibial joint space).
Results: Mean age of the patients was 64.81 ± 11.22 years. Female patients accounted for 75.6 % (n = 87), with a female / male ratio of 3 : 1. Biochemical-variables: CRP decreased from 0.42 ± 0.54 mg/dL to 0.31 ± 0.33 mg/dL (p = 0.0142). ESR decreased from 14.52 ± 10.14 mm/h to 13.08 ± 8.78 mm/h (p= 0.0014). Serum uric acid decreased from 5.12 ± 1.22 mg/dL to 5.05 ± 1.24 (p = 0.1307).
Clinical variables: Ozone (O2-O3) significantly improved pain, stiffness and function clinical variables (p = 0.0000). Pain measured by VAS was 7.11 ± 1.11 points and decreased significantly to 3.56 ± 1.56 points (p = 0.0000). Before the intervention, WOMAC-pain subscale was 14.3 ± 22.29 points and decreased to 7.13 ± 33.13 points (p = 0.0000), WOMAC-stiffness subscale was 2.73 ± 1.39 points and decreased to 1.16 ± 1.13 points (p = 0.0000), WOMAC-function subscale was 41.66 ± 8, 1 points and improved to 25.29 ± 9.72 points (p = 0.0000).
Radiological variables: In 53 patients analyzed radiologically (according to standardized protocol) at one year of follow-up after ozone treatment, the internal compartment increased significantly from 4.12 ± 1.41 mm to 4.4 ± 1.35 mm (p = 0.0008) and the external compartment increased from 6 ± 1.37 to 6.16 ± 1.4 mm (p = 0.0753).
Conclusions: Intra articular ozone has demonstrated a symptomatic and disease modifying effect in patients with osteoarthritis of the knee, improving pain, function and stiffness; decreasing markers of inflammation (CRP, ESR and uric acid), and increasing the minimal joint space of the medial and lateral component evidenced radiologically. In this study it has been shown that ozone modulates inflammation, decreases pain and stiffness, improves function and has an anabolic effect in patients with osteoarthritis of the knee. No adverse effect has been observed after intra articular infiltrations of ozone.



RESUMEN

Objetivo: El objetivo del presente estudio es verificar por primera vez en la literatura el efecto sintomático y modificador de enfermedad del ozono (O2-O3) mediante la mejoría clínica (dolor, función y rigidez), bioquímica (proteína C-reactiva [PCR], velocidad de sedimentación globular [VSG], ácido úrico) y radiológica (mínimo espacio articular medial y lateral) en una serie de pacientes con artrosis de rodilla.
Material y métodos: Se realizó un estudio cuasiexperimental prospectivo tipo antes y después a 115 pacientes con artrosis de rodilla con Kellgren-Lawrence grado 2 o más. El protocolo de ozono consistió en 4 sesiones (una sesión/semana) de una infiltración intrarticular de 20 ml de una mezcla médica de oxígeno-ozono (95-5 %) a una concentración de 20 μg/ml. Las variables de resultado incluyeron variables clínicas (dolor, rigidez y función), bioquímicas (PCR, VSG, ácido úrico) y radiológicas (mínimo espacio articular femorotibial).
Resultados: La edad media de los pacientes fue de 64.81 ± 11.22 años. Los pacientes femeninos representaron el 75.6 % (n = 87), con una relación mujer/hombre de 3:1.
Variables bioquímicas: la PCR disminuyó de 0.42 ± 0.54 mg/dl a 0.31 ± 0.33 mg/dl (p = 0.0142). La VSG disminuyó sus valores desde 14.52 ± 10.14 mm/h hasta 13.08 ± 8.78 mm/h (p = 0,0014). El ácido úrico en suero disminuyó su valor de 5.12 ± 1.22 mg/dl a 5.05 ± 1.24 (p = 0.1307).
Variables clínicas: el ozono (O2-O3) mejoró significativamente las variables clínicas dolor, rigidez y función (p = 0.0000). El dolor medido por EVA fue de 7.11 ± 1.11 puntos y disminuyó significativamente a 3.56 ± 1.56 puntos (p = 0.0000). Antes de la intervención, la subescala WOMAC-dolor fue de 14.3 ± 2.29 puntos y disminuyó a 7.13 ± 3.13 puntos (p = 0.0000), la subescala WOMAC-rigidez fue de 2.73 ± 1.39 puntos y disminuyó a 1.16 ± 1.13 puntos (p = 0.0000), la subescala WOMAC-función fue de 41.66 ± 8.1 puntos y mejoró a 25.29 ± 9.72 puntos (p = 0.0000).
Variables radiológicas: en 53 pacientes analizados radiológicamente (según protocolo estandarizado) al año de seguimiento después del tratamiento con ozono, el compartimento interno aumento significativamente de 4.12 ± 1.41 mm a 4.4 ± 1.35 mm (p = 0.0008) y el compartimento externo aumentó de 6 ± 1.37 a 6.16 ± 1.4 mm (p = 0.0753).
Conclusiones: El ozono intrarticular ha demostrado efecto sintomático y modificador de la enfermedad en los pacientes con artrosis de rodilla, mejorando el dolor, la función y la rigidez; disminuyendo los marcadores de inflamación (PCR, VSG y ácido úrico), y aumentando el mínimo espacio articular del componente medial y lateral evidenciado radiológicamente. En este estudio se ha evidenciado que el ozono modula la inflamación, disminuye el dolor y la rigidez, mejora la función y tiene efecto anabólico en los pacientes con artrosis de rodilla. No se ha observado ningún efecto adverso tras las infiltraciones intrarticulares de ozono.





Complete Article

Bibliografía

1. Fernández-Cuadros ME, Pérez-Moro OS, Albaladejo-Florín MJ. Ozone fundamentals and effectiveness in knee pain: Chondromalacia and knee osteoarthritis. Germany: Lambert Academic Publishing; 2016.
2. Fernández-Cuadros ME. Análisis de la calidad de vida en pacientes con prótesis de rodilla. Tesis doctoral. Universidad de Salamanca. España. 2013.
3. Raynauld JP, Pelletier JP, Abram F, Dodin P, Delorme P, Martel‐Pelletier J. Long‐term effects of glucosamine and chondroitin sulfate on the progression of structural changes in knee osteoarthritis: six‐year follow-up data from the Osteoarthritis Initiative. Arthritis Care Res (Hobboken). 2016;68(10):1560-6. DOI: 10.1002/acr.22866.
4. Fernández‐Cuadros ME. Does glucosamine/chondroitin sulfate have a long‐term effect on the progression of structural changes in knee osteoarthritis? Comment on the article by Raynauld et al. Arthritis Care Res (Hobboken). 2018;70(1):167. DOI: 10.1002/acr.23313.
5. Fernández-Cuadros ME, Perez-Moro OS, Miron-Canelo JA. Could ozone be used as a feasible future treatment in osteoarthritis of the knee. Diversity Equal Health Care. 2016;13(3):232-9.
6. Fernandez-Cuadros ME, Perez-Moro OS, Albaladejo-Florin MJ, Algarra-Lopez R. Ozone decreases biomarkers of inflammation (C-reactive protein and erytrocyte sedimentation rate) and improves pain, function and quality of life in knee osteoarthritis patients: a before-and-after study and review of the literature. Middle East J Rehabil Health Stud. 2018; 5(2):e64507. DOI: 10.5812/mejrh.64507.
7. Fernández-Cuadros ME, Pérez-Moro OS, Albaladejo-Florín MJ, Algarra-Lopez R. Intra articular ozone reduces serum uric acid and improves pain, function and quality of life in knee osteoarthritis patients: a before-and-after study. Middle East J Rehabil Health Stud. 2018;5(3):e68599. DOI: 10.5812/mejrh.68599.
8. Fernández-Cuadros ME, Pérez-Moro OS, Albaladejo-Florín M, Mirón-Canelo JA. Ozone improves pain, function and quality of life in patients with knee osteoarthritis: A prospective quasi-experimental before-after study. Middle East J Rehabil Health Stud. 2017;4(1):e41821. DOI: 10.17795/mejrh-41821.
9. Fernández-Cuadros ME, Pérez-Moro OS, Albaladejo-Florín MJ. Knee osteoarthritis: Condroprotector action and symptomatic effect of ozone on pain, function, quality of life, minimal joint space and knee arthroplasty delay. Middle East J Rehabil Health Stud. 2017;4(1):e43200. DOI: 10.17795/mejrh-43200.
10. Buckland-Wright JC, Macfarlane DG, Williams SA, Ward RJ. Accuracy and precision of joint space width measurements in standard and macroradiographs of osteoarthritic knees. Ann Rheum Dis, 1995;54(11):872-80. DOI: 10.1136/ard.54.11.872.
11. Pérez-Moro O, Albaladejo-Florín M, Entrambasaguas-Estepa B, Fernández-Cuadros, M. Effectivenness of PRP on pain, function and quality of life in chondromalacia and patellofemoral pain syndrome: A pretest-postest analysis. Nov Tech Arthritis Bone Res. 2017;1(1):1-8.
12. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15(12):1833-40.
13. Malathi R, Kothari S, Chattopadhyay A, Agrawal PK, Banerjee U, Sahu RK. Raised serum IL 6 and CRP in radiographic knee osteoarthritis in Eastern India. JMSR. 2017;5(5):21687-92. DOI: 10.18535/jmscr/v5i5.73.
14. Ayral X, Pickering EH, Woodworth TG, Mackillop N, Dougados M. Synovitis: a potential predictive factor of structural progression of medial tibiofemoral knee osteoarthritis–results of a 1 year longitudinal arthroscopic study in 422 patients. Osteoarthritis Cartilage. 2005;13(5):361-7. DOI: 10.1016/j.joca.2005.01.005.
15. Smith JW, Martins TB, Gopez E, Johnson T, Hill HR, Rosenberg T D. Significance of C-reactive protein in osteoarthritis and total knee arthroplasty outcomes. Ther Adv Musculoskelet Dis. 2012;4(5):315-25. DOI: 10.1177/1759720X12455959.
16. Lotz M, Martel-Pelletier J, Christiansen C, Brandi ML, Bruyère O, Chapurlat R, et al. Value of biomarkers in osteoarthritis: current status and perspectives. Ann Rheum Dis. 2013;72(11):1756-63. DOI: 10.1136/annrheumdis-2013-203726.
17. Spector TD, Hart DJ, Nandra D, Doyle DV, Mackillop N, Gallimore JR, Pepys MB. Low‐level increases in serum C‐reactive protein are present in early osteoarthritis of the knee and predict progressive disease. Arthritis Rheum. 1997;40(4):723-7. DOI: 10.1002/art.1780400419.
18. Arendt‐Nielsen L, Eskehave TN, Egsgaard LL, Petersen KK, Graven‐Nielsen T, Hoeck HC, et al. Association between experimental pain biomarkers and serologic markers in patients with different degrees of painful knee osteoarthritis. Arthritis Rheumatol, 2014;66(12):3317-26. DOI: 10.1002/art.38856.
19. Sanchez-Ramirez DC, van der Leeden M, van der Esch M, Gerritsen M, Roorda LD, Verschueren S, et al. Association of serum C-reactive protein and erythrocyte sedimentation rate with muscle strength in patients with knee osteoarthritis. Rheumatology (Oxford). 2012;52(4):727-32. DOI: 10.1093/rheumatology/kes366.
20. Zhu Z, Jin X, Wang B, Wluka A, Antony B, Laslett L, et al. Cross-sectional and longitudinal associations between serum levels of high-sensitivity C-reactive protein, bone marrow lesions, and knee pain in patients with knee osteoarthritis. Arthritis Care Res (Hoboken). 2016;68(10):1471-77. DOI: 10.1002/acr.22834.
21. Roddy E, Doherty M. Gout and osteoarthritis: a pathogenetic link? Joint Bone Spine. 2012;79(5):425-7. DOI: 10.1016/j.jbspin.2012.03.013.
22. Ma CA, Leung YY. Exploring the link between uric acid and osteoarthritis. Front Med (Lausanne). 2017;4:225. DOI: 10.3389/fmed.2017.00225.
23. Martinon F, Pétrilli V, Mayor A, Tardivel A, Tschopp J. Gout-associated uric acid crystals activate the NALP3 inflammasome. Nature. 2006;440(7081):237. DOI: 10.1038/nature04516.
24. Denoble AE, Huffman KM, Stabler TV, Kelly SJ, Hershfield MS, McDaniel GE, et al. Uric acid is a danger signal of increasing risk for osteoarthritis through inflammasome activation. Proc Natl Acad Sci U S A. 2011;108(5):2088-93. DOI: 10.1073/pnas.1012743108.
25. Bonora E, Targher G, Zenere MB, Saggiani F, Cacciatori V, Tosi F, et al. Relationship of uric acid concentration to cardiovascular risk factors in young men. Role of obesity and central fat distribution. The Verona Young Men Atherosclerosis Risk Factors Study. Int J Obes Relat Metab Disord. 1996;20(11):975-80.
26. Lyngdoh T, Marques-Vidal P, Paccaud F, Preisig M, Waeber G, Bochud M,et al. Elevated serum uric acid is associated with high circulating inflammatory cytokines in the population-based Colaus study. PLoS One. 2011;6(5):e19901. DOI: 10.1371/journal.pone.0019901.
27. Wangkaew S, Kasitanon N, Hongsongkiat S, Tanasombat C, Sukittawut W, Louthrenoo W, et al. A comparative study of serum and synovial fluid levels of uric acid between patients with gout and other arthritides. J Med Assoc Thai. 2014;97(7):679-85.
28. Billiet L, Doaty S, Katz JD, Velasquez MT. Review of hyperuricemia as new marker for metabolic syndrome. ISRN Rheumatol. 2014;2014:852954. DOI: 10.1155/2014/852954.
29. Cho HJ, Chang CB, Yoo JH, Kim SJ, Kim TK. Gender differences in the correlation between symptom and radiographic severity in patients with knee osteoarthritis. Clin Orthop Relat Res. 2010;468(7):1749-58. DOI: 10.1007/s11999-010-1282-z.
30. Neumann G, Hunter D, Nevitt M, Chibnik LB, Kwoh K, Chen H, et al. Location specific radiographic joint space width for osteoarthritis progression. Osteoarthritis Cartilage. 2009;17(6):761-5. DOI: 10.1016/j.joca.2008.11.001.
31. Mazzuca SA, Brandt KD, Katz BP. Is conventional radiography suitable for evaluation of a disease-modifying drug in patients with knee osteoarthritis? Osteoarthritis Cartilage. 1997;5(4):217-26. DOI: 10.1016/S1063-4584(97)80017-9.
32. Altman RD, Fries JF, Bloch DA, Carstens J, Cooke TD, Genant H, et al. Radiographic assessment of progression in osteoarthritis. Arthritis Rheum. 1987;30(11):1214-25. DOI: 10.1002/art.1780301103.
33. Conrozier T, Favret H, Mathieu P, Piperno M, Provvedini D, Taccoen A, et al. Influence of the quality of tibial plateau alignment on the reproducibility of computer joint space measurement from Lyon schuss radiographic views of the knee in patients with knee osteoarthritis. Osteoarthritis Cartilage. 2004;12(10):765-70. DOI: 10.1016/j.joca.2004.06.003.
34. Altman R, Brandt K, Hochberg M, Moskowitz R, Bellamy N, Bloch DA,.et al. Design and conduct of clinical trials in patients with osteoarthritis: recommendations from a task force of the Osteoarthritis Research Society: results from a workshop. Osteoarthritis Cartilage. 1996;4(4):217-43. DOI: 10.1016/S1063-4584(05)80101-3.
35. Cicuttini F, Hankin J, Jones G, Wluka A. Comparison of conventional standing knee radiographs and magnetic resonance imaging in assessing progression of tibiofemoral joint osteoarthritis. Osteoarthritis Cartilage. 2005;13(8):722-7. DOI: 10.1016/j.joca.2005.04.009.
36. Cicuttini F, Hankin J, Jones G, Wluka A. Comparison of conventional standing knee radiographs and magnetic resonance imaging in assessing progression of tibiofemoral joint osteoarthritis. Osteoarthritis Cartilage. 2005;13(8):722-7. DOI: 10.1016/j.joca.2005.04.009.
37. Noori-Zadeh A, Bakhtiyari S, Khooz R, Haghani K, Darabi S. Intra-articular ozone therapy efficiently attenuates pain in knee osteoarthritic subjects: A systematic review and meta-analysis. Complement Ther Med. 2019;42:240-7. DOI: 10.1016/j.ctim.2018.11.023.
38. Arias-Vázquez PI, Tovilla-Zárate CA, Bermudez-Ocaña DY, Legorreta-Ramírez BG, López-Narváez ML. Eficacia de las infiltraciones con ozono en el tratamiento de la osteoartritis de rodilla vs. otros tratamientos intervencionistas: revisión sistemática de ensayos clínicos. Rehabilitación. 2019;53(1):43-55. DOI: 10.1016/j.rh.2018.11.001.
39. Sconza C, Respizzi S, Virelli L, Vandenbulcke F, Iacono F, Kon E, et al. Oxygen–ozone therapy for the treatment of knee osteoarthritis: a systematic review of randomized controlled trials. Arthroscopy. 2020;36(1):277-86.
40. Oliviero A, Giordano L, Maffulli N. The temporal effect of intra-articular ozone injections on pain in knee osteoarthritis. Br Med Bull. 2019;132(1):33-44. DOI: 10.1093/bmb/ldz028.

Tablas y Figuras

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Table II

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Prevalence of breakthrough pain associated with chronic low back pain in Andalusia (COLUMBUS study)

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Instrucciones para citar

Fernández-Cuadros M, Pérez-Moro O, Albaladejo-Florin M, Álava S. Intra-articular ozone modulates inflammation, ameliorates pain and stiffness, improves function and has anabolic effect on knee osteoarthritis: a prospective quasiexperimental before-and-after study, 115 patients. Rev Soc Esp Dolor 2020; 27(2): 78-88 / DOI: 1020986/resed20203775/2019


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Recibido: 28/10/2019

Aceptado: 16/02/2020

Prepublicado: 16/03/2020

Publicado: 17/04/2020

Tiempo de revisión del artículo: 107 días

Tiempo de prepublicación: 140 días

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© 2020 Revista de la Sociedad Española del Dolor
ISSN: 1134-8046   e-ISSN: 2254-6189

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