effect of intraarticular injection of ozone on inflammatory cytokines in knee osteoarthritis

introduction: knee osteoarthrosis is one of the most debilitating diseases. prolotherapy includes intraarticular injection of various drugs to decrease inflammation. injection of intradiscal o2-o3 has reduced pain and disability of patients with low back pain due to prolapsed lumbar disk. objective: to compare the effect of intraarticular injection of ozone and steroids in improvement of clinical and cellular healing of knee osteoarthritis. methods: in a randomized clinical trial, 70 patients with knee osteoarthrosis were included in the study. in ozone group, 5 ml (35 μg/ml) of ozone and in steroid group 5ml (50 mg) triamcinolone were injected intraarticular. at 1,2,and 6 month patients were followed for pain scale, disability index and il-1β and tnf-α serum levels were measured. results: at 1 month after injection pain scale and disability index and il-1β and tnf-α were decreased in both groups. however, at 2 and 6 month pain scale and disability index were significantly lower in ozone group compare to steroid group (p<0.05). besides, serum level of il-1β and tnf-α were also significantly lower at 2 and 6 month in ozone group compare to steroid group (p<0.05). conclusion: intraarticular ozone induces significantly longer improvement of pain and disability in knee osteoartherosis compare to steroid injection. in addition, serum inflammatory cytokines are also lower in ozone group compared to steroid group along with clinical improvements.