Integration of focal vibration and intra-articular oxygen–ozone therapy in rehabilitation of painful knee osteoarthritis

Abstract

Objective To examine the pain-reducing effects of intra-articular oxygen–ozone (O 2 O 3 ) injections and mechanical focal vibration (mFV) versus O 2 O 3 injections alone in patients with knee osteoarthritis. Methods Patients with chronic pain (>6 weeks) due to knee osteoarthritis (II–III on the Kellgren–Lawrence scale) were consecutively enrolled and divided into two groups: O 2 O 3 (n = 25) and O 2 O 3 -mFV (n = 24). The visual analog scale (VAS), Knee Injury and Osteoarthritis Outcome Score (KOOS), and Medical Research Council (MRC) Manual Muscle Testing scale were administered at baseline (before treatment), after 3 weeks of treatment, and 1 month after the end of treatment. Patients received three once-weekly intra-articular injections of O 2 O 3 into the knee (20 mL O 3 , 20 μg/mL). The O 2 O 3 -mFV group also underwent nine sessions of mFV (three sessions per week). Results The VAS score, KOOS, and MRC score were significantly better in the O 2 O 3 -mFV than O 2 O 3 group. The within-group analysis showed that all scores improved over time compared with baseline and were maintained even 1 month after treatment. No adverse events occurred. Conclusion An integrated rehabilitation protocol involving O 2 O 3 injections and mFV for 3 weeks reduces pain, increases autonomy in daily life activities, and strengthens the quadriceps femoris.