Comparison of the Efficacy of Intra-articular Ozone,Platelet-Rich Plasma and Corticosteroid Treatment in the Management of Knee Osteoarthritis

Abstract

Objectives: This study compares the efficacy of intra-articular ozone, platelet-rich plasma (PRP), and corticosteroid (CS) injections in managing knee osteoarthritis (KOA), aiming to identify the most effective treatment strategy. Patients and Methods: This retrospective study included 108 KOA patients aged 40–70, who met the inclusion criteria and had accessible medical records, treated at the University of Health Sciences Kanuni Sultan Süleyman Training and Research Hospital between January 2020 and December 2022. Patients were divided into three groups of 36, each receiving either ozone, PRP, or CS injections. Pain and function were assessed using the visual analog scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Lequesne index, 15 m walking time, and number of steps ascended without discomfort, at baseline, 1 month, and 2 months posttreatment. Results: Baseline VAS scores were similar across groups (6.93 ± 1.93). After 1 month, significant reductions in VAS and WOMAC scores were observed in the CS and ozone groups (p < 0.05). PRP effects were more prominent after 2 months, showing significant improvement in VAS, WOMAC, and walking time (p < 0.05). Additionally, the number of steps ascended without discomfort increased significantly only in the PRP group by the second month. Conclusion: CS and ozone provided early pain relief, whereas PRP offered greater long-term benefits in pain reduction and functional improvement. PRP may be the preferred option for sustained symptom relief in KOA. Further studies are needed to confirm these findings and optimize treatment approaches.