{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T17:00:07Z","timestamp":1781715607438,"version":"3.54.5"},"reference-count":33,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2019,10,11]],"date-time":"2019-10-11T00:00:00Z","timestamp":1570752000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Osteoarthritis (OA) is a most common orthopaedic condition, often complicated by inflammatory features.<\/jats:p><\/jats:sec><jats:sec><jats:title>Sources of data<\/jats:title><jats:p>A systematic search in PubMed, Embase, Google Scholar and Scopus databases (to January 2019) was performed to define the effect obtained in patients with OA of the knee by injections of ozone, on pain and physical function. Six RCTs and 353 patients were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Areas of agreement<\/jats:title><jats:p>Recently, an increasing number of physicians have used ozone therapy to alleviate the symptoms of acute and chronic OA of the knee. Ozone can allow greater mobility of the knee joint, pain relief and decrease in effusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Areas of controversy<\/jats:title><jats:p>The volume and concentration of ozone injected are different in the various treatment protocols published.<\/jats:p><\/jats:sec><jats:sec><jats:title>Growing points<\/jats:title><jats:p>The action of ozone is unclear, but it is a promising therapeutic modality capable of impacting, favourably, function and quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>Areas timely for developing research<\/jats:title><jats:p>The lack of a clear protocol of use is a major limitation, and to date there is no clear evidence of long-term efficacy.<\/jats:p><\/jats:sec>","DOI":"10.1093\/bmb\/ldz028","type":"journal-article","created":{"date-parts":[[2019,8,2]],"date-time":"2019-08-02T19:09:25Z","timestamp":1564772965000},"source":"Crossref","is-referenced-by-count":12,"title":["The temporal effect of intra-articular ozone injections on pain in knee osteoarthritis"],"prefix":"10.1093","author":[{"given":"Antonio","family":"Oliviero","sequence":"first","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery, AOU San Giovanni di Dio e Ruggi D\u2019Aragona, Via San Leonardo 1, 84131 Salerno, Italy"},{"name":"Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, SA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Giordano","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery, AOU San Giovanni di Dio e Ruggi D\u2019Aragona, Via San Leonardo 1, 84131 Salerno, Italy"},{"name":"Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, SA, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Maffulli","sequence":"additional","affiliation":[{"name":"Department of Trauma and Orthopaedic Surgery, AOU San Giovanni di Dio e Ruggi D\u2019Aragona, Via San Leonardo 1, 84131 Salerno, Italy"},{"name":"Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, SA, Italy"},{"name":"Queen Mary University of London, Barts and the London School of Medicine and Dentistry, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London E1 4DG, England"},{"name":"Institute of Science and Technology in Medicine, Keele University School of Medicine, Thornburrow Drive, Stoke on Trent, ST5 5BG England"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2019,10,10]]},"reference":[{"key":"2019101021283981100_ref1","doi-asserted-by":"crossref","first-page":"6093","DOI":"10.3390\/ijms16036093","article-title":"Osteoarthritis in the XXIst century: risk factors and behaviours that influence disease onset and progression","volume":"16","author":"Musumeci","year":"2015 16","journal-title":"Int J Mol Sci"},{"key":"2019101021283981100_ref2","doi-asserted-by":"crossref","DOI":"10.1016\/j.jajs.2014.06.003","article-title":"Current concepts in articular cartilage repair","volume":"1","author":"Rambani","year":"2014 1","journal-title":"J Arthrosc Jt Surg"},{"key":"2019101021283981100_ref3","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0103056","article-title":"Genes involved in the osteoarthritis process identified through genome wide expression analysis in articular cartilage; the RAAK study","volume":"9","author":"Ramos","year":"2014","journal-title":"PloS One"},{"key":"2019101021283981100_ref4","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.joca.2014.11.019","article-title":"Current evidence on risk factors for knee osteoarthritis in older adults: a systematic review and meta-analysis","volume":"23","author":"Silverwood","year":"2015","journal-title":"Osteoarthr Cartil"},{"key":"2019101021283981100_ref5","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.maturitas.2011.12.001","article-title":"Genetics and epigenetics of osteoarthritis","volume":"71","author":"Reynard","year":"2012","journal-title":"Maturitas"},{"key":"2019101021283981100_ref6","doi-asserted-by":"crossref","first-page":"202","DOI":"10.22203\/eCM.v021a16","article-title":"Roles of inflammatory and anabolic cytokines in cartilage metabolism: signals and multiple effectors converge upon MMP-13 regulation in osteoarthritis","volume":"21","author":"Goldring","year":"2011 24","journal-title":"Eur Cell Mater"},{"key":"2019101021283981100_ref7","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1016\/j.joca.2007.09.012","article-title":"Reactive nitrogen and oxygen species in interleukin-1-mediated DNA damage associated with osteoarthritis","volume":"16","author":"Davies","year":"2008","journal-title":"Osteoarthr Cartil"},{"key":"2019101021283981100_ref8","first-page":"232","article-title":"Could ozone be used as a feasible future treatment in osteoarthritis of the knee?","volume":"13","author":"Fern\u00e1ndez-Cuadros","year":"2016","journal-title":"Divers Equal Health Care"},{"key":"2019101021283981100_ref9","doi-asserted-by":"crossref","DOI":"10.1155\/2014\/561459","article-title":"The role of inflammatory and anti-inflammatory cytokines in the pathogenesis of osteoarthritis [internet]","author":"Wojdasiewicz","year":"2014","journal-title":"Mediators Inflamm"},{"key":"2019101021283981100_ref10","doi-asserted-by":"crossref","first-page":"304","DOI":"10.2174\/0929867323666151221150420","article-title":"Ozone: a multifaceted molecule with unexpected therapeutic activity","volume":"23","author":"Zanardi","year":"2016","journal-title":"Curr Med Chem"},{"key":"2019101021283981100_ref11","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.arcmed.2005.08.006","article-title":"Scientific and medical aspects of ozone therapy. 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