The efficacy of ultrasonography-guided oxygen-ozone therapy versus corticosteroids in patients with knee osteoarthritis: A multicenter randomized controlled trial.

BACKGROUND: Osteoarthritis (OA) is a widely-known disease distinguished by the breakdown of joint cartilage, leading to pain and morning stiffness. In this context, the role of corticosteroids is well known, but there is still a gap of knowledge on the duty of oxygen-ozone therapy (O2-O3). OBJECTIVE: To evaluate for effectiveness of ultrasound-guided O2-O3 injections compared with corticosteroid injections among patients diagnosed with knee OA. METHODS: This randomized controlled clinical trial was conducted on participants with knee OA who were randomly sorted into two groups: group A, undergoing corticosteroid group (n= 47) and group B, undergoing O2-O3 (n= 49) were injected within the knee joint under ultrasound guidance. The primary outcome measure was the change in the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) score between baseline and 12-weeks post-injection. Secondary outcome measures included visual analog scale scores, joint effusion and a knee flexion ROM. Assessments were recorded at baseline and 4-weeks and 12-weeks post-injection. For the examination of intra- and inter-group variations at various time points, a repeated-measure analysis of variance (two-way ANOVA) was employed. RESULTS: Ninety-six participants completed this study. Based on repeated measurement analysis of variance, a significant effect of time was found for all outcome measures in both groups. Both groups showed clinically significant improvements in knee pain, quality of life and, function. Baseline, 4-week post-injection and 12-week post-injection WOMAC scores (mean ± standard deviation) were 72.54 ± 18.89, 45,95 ± 13.30 and 37.10 ± 19.87 (p= 0.00, p= 0.00, p= 0.00; respectively) in the corticosteroid group, respectively and 68.23 ± 20.18, 42.99 ± 18.67, and 33.43 ± 18.24 (p= 0.00, p= 0.00, p= 0.00; respectively) in the ozone group, respectively. However, no significant group × time interaction was determined regarding all outcome measures. CONCLUSION: The study demonstrates the efficacy of O2-O3 compared to steroid injections regarding functioning and pain relief among patients with diagnosed knee OA.

Fibrous dysplasia and McCune-Albright syndrome: A case report with review of literature on the rehabilitation approach.

McCune-Albright syndrome is classically defined by the clinical triad of fibrous dysplasia (FD) of the bone, café-au-lait macules, and endocrinopathies. We report the case of a 15-year-old male with a diagnosed with McCune Albright syndrome. McCune-Albright syndrome remains a diagnostic challenge, and delayed diagnosis may have significant consequences. Routine musculoskeletal screening along with other endocrinopathies should be kept in mind. The rehabilitation programs that provides significant improvement in their quality of life. The treatment of McCune-Albright syndrome is directed toward the specific symptoms that are apparent in each individual.

Comparison of the efficacy of oxygen-ozone and lidocaine injections in the treatment of myofascial pain syndrome: A randomized clinical trial.

Objectives: This study aims to compare effectiveness of oxygen-ozone injection versus lidocaine injection on the trigger point in the treatment of myofascial pain syndrome (MPS). Patients and methods: Between April 2021 and December 2021, a total of 46 patients with MPS (8 males, 38 females; mean age: 44.7±10.4 years; range, 25 to 65 years) were included. The patients were randomized to either ozone injection (n=23) or lidocaine injection (n=23) groups. All injections were administered once a week for three consecutive weeks. The primary outcome measure was the pain severity assessed by Visual Analog Scale (VAS). Secondary outcome measures were cervical lateral flexion range of motion (ROM), pain score (PS), and Neck Disability Index (NDI). The measurements were performed before the treatment, and at four and 12 weeks after treatment. Results: There was a significant effect of time for VAS, PS, and NDI scores in both groups. Compared to baseline versus Weeks 4 and 12, the VAS, PS, and NDI scores significantly decreased over time in both groups (p<0.001 for all). A significant group X time interaction was identified regarding the VAS scores. The mean difference in the VAS scores over time was significantly higher in the lidocaine group compared to the oxygen-ozone group (p=0.028). Conclusion: Oxygen-ozone and lidocaine injections of the trigger point can effectively improve pain and functional status. However, lidocaine injection appears to be superior in reducing pain compared to oxygen-ozone injection, but is not superior in improving function and PS.

Sarcopenia in knee osteoarthritis: the association with clinical and sonographic findings, physical function, and nutrition.

OBJECTIVE: The purposes of this study were to examine to (1) the relation between OA and sarcopenia and to identify the most practical, easily accessible, and inexpensive method for investigating sarcopenia; (2) evaluation of sarcopenia risk factors in patients with OA. DESIGN: One hundred two patients with clinical and radiological diagnosis of knee osteoarthritis and 33 healthy control subjects were included in the study and all subjects were evaluated for sarcopenia. Dual-X-ray absorptiometry (DEXA) is used to measure body composition parameters and muscle thickness measurements with ultrasonography for diagnosis of sarcopenia. RESULTS: The mean age of the group with sarcopenia was statistically higher than the other two groups (p < 0.001). The weight, body mass index (BMI), waist circumference, upper-mid-arm circumference, thigh, and leg circumference of osteoarthritis (OA) patients with sarcopenia were statistically lower than those of non-sarcopenic and control group (p < 0.01, p < 0.001). Body composition parameter results showed that sarcopenic patients had statistically lower values as fat mass, lean body mass, and skeletal muscle index (p < 0.001, p = 0.001, p < 0.001, respectively) than those of non-sarcopenic and control group and fat mass index values (p = 0.012) are lower than the non-sarcopenic group. With respect to sarcopenia, the effect of adiponectin and leptin levels were not detected. It was determined that body composition values measured with DEXA, ultrasonographic measures, isokinetic muscle strength assessment, handgrip strength, and gait speed had predictive values for sarcopenia. CONCLUSIONS: We found that patients with sarcopenic OA were older, weaker, undernourished, and restricted in their level of physical activity in the study. Among the methods of determining sarcopenia, ultrasound becomes prominent with its practical, cheap, and easily accessible features. We think that our results will increase the awareness of the presence of sarcopenia in OA patients.

Comparison of ultrasound-guided subacromial corticosteroid and ozone (O2-O3) injections in the treatment of chronic rotator cuff tendinopathy: a randomized clinical trial.

Background: : The authors aimed to compare the effects of a one-time ultrasound (US)-guided subacromial corticosteroid injection and three-time ozone (O2-O3) injection in patients with chronic supraspinatus tendinopathy. Methods: : Participants were randomly assigned to the corticosteroid group (n = 22) or ozone group (n = 22). Injections in both groups were administered into subacromial bursa with an US-guided in-plane posterolateral approach. Primary outcome measure was the change in the Western Ontario Rotator Cuff Index (WORC) score between baseline and 12-weeks post-injection. Secondary outcome measures included visual analog scale and Shoulder Pain and Disability Index scores. Assessments were recorded at baseline, and 4-weeks and 12-weeks post-injection. Results: : Forty participants completed this study. Based on repeated measurement analysis of variance, a significant effect of time was found for all outcome measures in both groups. Both the groups showed clinically significant improvements in shoulder pain, quality of life, and function. Baseline, 4-week post-injection, and 12-week post-injection WORC scores (mean ± standard deviation) were 57.91 ± 18.97, 39.10 ± 20.50 and 37.22 ± 27.31 in the corticosteroid group, respectively and 69.03 ± 15.89, 39.11 ± 24.36, and 32.26 ± 24.58 in the ozone group, respectively. However, no significant group × time interaction was identified regarding all outcome measures. Conclusions: : Three-time ozone injection was not superior to a one-time corticosteroid injection in patients with chronic supraspinatus tendinopathy. It might be as effective as corticosteroid injection at 4-weeks and 12-weeks post-injection in terms of relieving pain and improving quality of life and function.