Comparising the efficacy and safety of intra-articular injection with ozone, sodium hyaluronate or chondroitin sulfate in the knee joint cavity respectively for the treatment of patients with knee osteoarthritis

Abstract

Objective To investigate the efficacy and safety of intra-articular injection with ozone, sodium hyaluronate or chondroitin sulfate in knee joint cavity respectively for the treatment of patients with knee osteoarthritis. Methods One hundred and forty-nine patients with knee osteoarthritis, both sexes, aged≥18 years, from January 2016 to December 2017 in Department of Pain Medicine, Orthopedic Hospital of Guizhou Province, were randomly divided into three groups. Different medicines were injected into the knee joint cavity, ozone in group A(50 cases), sodium hyaluronate in group B(49 cases) and chondroitin sulfate in group C(50 cases), once a week, five times in a course. The number of cases with discomfort during injection was recorded in three groups. Heart rate, blood pressure and blood oxygen saturation were observed before the injection, and at injection time, 1 minute and 5 minutes after the injection. Visual analogue score (VAS) and Lysholm scores were recorded before the treatment, and at 1 time, 5 times injection, and at 1 month, 3 months after the treatment. Results Compared with pre-injection, heart rate was significantly increased during the injection in group A[(94±10)vs.(78±9)](P<0.05). Compared with group A, the discomfort cases were fewer and heart rate were lower during the injection in group B and group C (5 vs. 27 cases, 3 vs. 27 cases)[(85±9)vs.(94±10), (83±8)vs.(94±10)](all P<0.05). VAS was lower and Lysholm score was higher in group A and group B at each time point after the treatment than those in pre-treatment (all P<0.05), while there were significant differences in VAS and Lysholm score at 5 times injection and 1 month after the treatment in group C(all P<0.05). Compared with group A and group B, VAS was increased and Lysholm score was decreased respectively at each time point after the treatment in group C (all P<0.05). Conclusion Intra-articular injection of ozone or sodium hyaluronate is effective for the treatment of patients with osteoarthritis, while the efficacy is poorer with chondroitin sulfate, there are more patients with discomfort and heart rate increase during the ozone injection. Key words: Ozone; Hyaluronic acid; Chondroitin; Injections, intra-articular; Osteoarthritis, knee