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Ozone Gas Injections may do the Trick for Knee Osteoarthritis

SAN FRANCISCO — Injecting ozone gas into the knee reduces pain and improves functioning and quality of life in people with knee osteoarthritis, according to research presented this week at the American College of Rheumatology Annual Meeting in San Francisco.

Osteoarthritis, sometimes called degenerative joint disease, is a slowly progressive disease in which joint cartilage breaks down. Normally, cartilage on the ends of bones allows smooth, pain-free joint movements. In OA, cartilage becomes thin and irregular, resulting in symptoms of joint pain and stiffness. Grinding or cracking sensations may occur. Joints that are under high stress due to repeated activity or weight bearing are most susceptible to OA. The hips, knees, hands and spine are commonly affected. OA becomes more common with aging.

OA is often the cause of severe pain, disability, reduction in quality of life and significant social and economic burdens. So, researchers from Brazil recently looked at an alternative therapy of injecting ozone gas — a naturally-occurring gas that consists of three atoms of oxygen and shows promise to reduce inflammation and balance free radicals in the body—into the knee to determine if that could reduce pain and improve functioning and quality of life for these patients.

The researchers, led by Carlos César Lopes de Jesus and Virginia Fernandes Moça Trevisani, PhD followed 98 people through the course of the study. Sixty-three of the participants received 10ml injections of ozone throughout the study, and 35 received 10ml injections of air as a placebo. All of the participants had similar socioeconomic backgrounds, and only two participants (both in the ozone group) did not finish the study.

The researchers performed several evaluations of the participants at the beginning of the study as well as after their fourth and eight injections and eight weeks after their last injection. They were looking at changes in pain; function; ability to sit, stand and walk; as well as other quality of life indicators. 

Timed up and go tests (TUG tests) were performed to evaluate the time it takes a participant to stand up, walk a set distance, return and sit, and there were no significant differences in how the two groups performed in these tests. The group on ozone therapy, however, had significantly better results in tests that measured pain, function, and overall health, which showed significant improvements in the ozone group throughout the course of the study.

Finally, an evaluation of quality of life (obtained using the Short Form-36 Health Survey) showed participants in the ozone group reported improvement in all areas that pertain to quality of life after their fourth injection.

“We think the work means that ozone can give the patient a better quality of life with less pain and more independence in daily life activities, explains de Jesus and Dr. Trevisani, a PhD student and professor at Federal University of São Paulo – Paulista School of Medicine in Brazil, respectively. “Ozone is also capable of delaying the need for joint replacement surgery. It is a tool for the clinician to reduce pain or to help control it.”

The researchers believe that more studies are needed to confirm their results and to show that ozone may be an alternative treatment option for patients who suffer with osteoarthritis. Their next step is to initiate a similar study evaluating the patients with a CT scan or ultrasound. 

Jocelyn Givens
During Annual Meeting: Newsroom – 415-978-3605 or 415-978-3604
Office – 404-633-3777, ext. 810


About the American College of Rheumatology

Headquartered in Atlanta, Ga., the American College of Rheumatology is an international medical society representing over 9,400 rheumatologists and rheumatology health professionals with a mission to Advance Rheumatology! In doing so, the ACR offers education, research, advocacy and practice management support to help its members continue their innovative work and provide quality patient care. Rheumatologists are experts in the diagnosis, management and treatment of more than 100 different types of arthritis and rheumatic diseases. For more information, visit

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