Efficacy of Intra-Articular Ozone Versus Hyaluronic Acid In Patients of Knee Osteoarthritis


  • Muhammad Tahseen Talib Department of Pain Medicine, Combined Military Hospital Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
  • Muhammd Rashid Iqbal Department of Pain Medicine, Combined Military Hospital Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
  • Moazzam ali Department of Pain Medicine, Combined Military Hospital Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan
  • Uzma Tahseen Department of Medicine, Rawalpindi Medical University Rawalpindi Pakistan
  • Shmyla Hamid Department of Medicine, Shifa International Hospital Islamabad Pakistan
  • Maliha Khawar Department of Medicine, Pak Emirates Military Hospital Rawalpindi/ National University of Medical Sciences (NUMS) Pakistan




Hyaluronic acid, Osteoarthritis, Pain, Pain Measurement, Analgesia


Objective: To determine the analgesic efficacy of ozone gas versus hyaluronic acid solution in knee osteoarthritis patients.

Study Design: Quasi-experimental study.

Place and duration of study: Department of Pain Medicine, Combined Military Hospital, Rawalpindi Pakistan, from Jun to Dec 2020.

Methodology: Seventy patients suffering from knee osteoarthritis fulfilling the inclusion criteria were included in this study and were randomly assigned to two equal groups to undergo intra-articular knee injection using either Hyaluronic Acid (Group-H) or Ozone (Group-O). Improvement in the numeric rating scale (NRS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scale were recorded 1, 3 and 6 months after the procedure.

Results: In both groups, the pain score (Group-H Pre-procedure NRS =7.66±0.87 vs. Post-Procedure 6 month NRS = 4.74±0.70, Group-O Pre-procedure NRS = 7.86±0.88 vs. Post-Procedure 6 month NRS = 4.46±0.92) and WOMAC (Group-H Pre-procedure =77.60±7.93 vs. Post-Procedure 6 month =40.31±6.81, Group-O Pre-procedure=75.54±9.40 vs. Post-Procedure 6 month =38.37±8.98) score improved. However, the NRS pain score (p-value = 0.21) and patient WOMAC score (p-value = 0.31) were not significantly different between groups.

Conclusion: Neither Hyaluronic Acid nor Ozone appears superior in decreasing pain scores or physical limitations, particularly for knee osteoarthritis.


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How to Cite

Muhammad Tahseen Talib, Muhammd Rashid Iqbal, ali, M., Uzma Tahseen, Shmyla Hamid, & Maliha Khawar. (2024). Efficacy of Intra-Articular Ozone Versus Hyaluronic Acid In Patients of Knee Osteoarthritis. Pakistan Armed Forces Medical Journal, 74(1), 160–163. https://doi.org/10.51253/pafmj.v74i1.6957



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