Integration of focal vibration and intra-articular oxygen–ozone therapy in rehabilitation of painful knee osteoarthritis
Teresa Paolucci, Francesco Agostini, Andrea Bernetti, Marco Paoloni, Massimiliano Mangone, Valter Santilli, Letizia Pezzi, Rosa Grazia Bellomo, Raoul Saggini
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.