Comparıson between clınıcal effects of ıntra-artıcular ozone and intra-articular steroıd injection ın the treatment of chronic ankle osteoarthrıtıs

Comparsion between effects of intra-articular injection of corticosteroid and ozone on pain and function of ankle in osteoarthritis of ankle

The randomized trial, parallel groups; single-blind, 40 patients, phase 2-3, using permuted block randomization.

5 cc of ozone with a concentration of 30 micrograms per milliliter was injected into the joint. Ozone injections were once a week for 3 weeks. In corticosteroid group we injected 40 mg teriamcinolon. The injection site was Mortis ankle joint Patient’s position was supine and ankle was in neutr position . In the ozone therapy group before the start of the study, at the end of the third session, one month after and 6 months after the end of the ozone therapy sessions, and in the steroid therapy group before the start of the study, one month after the methylprednisolone injection and 6 months after the injection , The following items were recorded for each patient: Pain by theoretical analog scale (VAS) 2) FADI) Foot And Ankle Disability Index)

Inclusion criteria: Moderate ankle osteoarthritis, Existence of symptoms of ankle osteoarthritis for at least 3 months, Minimum score of 3 in (VAS) criteria, Absence of inflammatory rheumatic diseases, Aged 45 years and older; Failure in conservative medication and physiotherapy treatments during the past 6 months. Exclusion criteria: Severe osteoarthritis, Rheumatic disease, Clearly visible deformity of the ankle, Ankylosis, Ozone contraindications, Definitive and relative contraindications to steroid injection, Artificial joint, Uncontrolled coagulation disorders, Specific skin lesion at the injection site.

1.Corticosteroid therapy 2.Ozone therapy

Function of ankle; Pain

Random allocation was performed using block randomization using software (RAS). The size of the blocks is 4, which includes an equal number of each intervention with a 1: 1 allocation ratio. Blocking is done by a person not involved in sampling and data analysis. To hide the allocation, the type of intervention was written on a piece of paper using the letters A and B and placed in matte and numbered envelopes. The envelopes were given to the participants in the order of the participants.

It was not possible to blind patients due to the difference in the injection material, so the volunteers were aware of what treatment method was used in each group. The injections were performed by a physical medicine specialist. Data researchers, data analyzers, and outcome evaluators were blind. They were not aware of the intervention performed on each group of patients. Only the final data in the form of the first and second groups and random numbers assigned to each patient was available.