Comparing Therapeutic Effects of Intraarticular Ozone and Hyaluronic Acid in the Rat Model of Experimental Knee Osteoarthritis

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Hakan Dayanır
Sevtap Han
Candan Özoğul
Avni C. Babacan
Orhan M. Uludağ
Duygu Dayanır


Purpose: In this study, we examined therapeutic effects of intraarticular ozone when compared with hyaluronic acid (HA) in the osteoarthritis model of rat. We investigated possible effects of those substances on inflammatory and nociceptive processes, both macroscobic and histological changes with differences on collagen structure in knee joints.

Methods: Intraarticular Kaolin-Carrageenan (CG) mixture was used to form osteoarthritis. In this study, 36 male Wistar albino rats were randomly divided into 6 groups including CG, CG+saline, CG+ozone, CG+HA, CG+ozone+HA and ozone-only. All therapeutic applications were performed to posterior right knee joints of rats and their posterior left knee joints were considered as their controls. As therapeutic protocols, 4 days after CG injections, three consecutive intraarticular applications were performed separately to the right knee joints by 4 days of intervals. Hot plate test was used for determination of antinociceptive effect and joint girths with knee diameters had been measured in a day before the beginning of experiments and the 16th day of this study. All rats were sacrified at 16th day and their posterior knee joints were dissected for histopathological examination.

Results: A statistically significant antinociceptive effect was observed in the ozone, HA and combination of Ozone+HA applications. Improvement of joint measurements was apparent with the ozone applications compared with HA group. When saline was applied to CG administered the joints, neither effect for reducing inflammation was observed in the arthritis. On the other hand, the ozone strongly reversed inflammation on the knee joints with carrageenan-induced arthritis. The histopathological appearance of joints obtained from both the ozone-applied and the control group were nearly similar to each other.

Conclusion: Ozone therapy has significant beneficial effects in terms of histopathological improvement, the antinociceptive effectiveness and knee joint measurements in osteoarthritis. These results suggested that both ozone alone and/or combination treatment have better therapeutic effects from HA alone.

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Author Biography

Hakan Dayanır

Ministry of Health, Dışkapı Yıldırım Beyazıt Teaching & Research Hospital, Ankara, Turkey;