Evidence map›Paper›PMID 42389359›Full record

SynthesisFrontiers in pain research (Lausanne, Switzerland)2026

The time-effect relationship of intra-articular ozone injection for knee osteoarthritis: a systematic review and meta-analysis.

Fengjiao Chen, Yufeng Tao, Jing Deng, Leyi Zhang, Lanlan Yu, Zhuoxi Yang, Yixuan Zhang, Chi Zhang

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in pain research (Lausanne, Switzerland), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Fengjiao ChenSchool of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Yufeng TaoSchool of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Jing DengSchool of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Leyi ZhangSchool of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Lanlan YuSchool of Clinical Medicine, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Zhuoxi YangSchool of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Yixuan ZhangSchool of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.
Chi ZhangSchool of Health Preservation and Rehabilitation, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: As a gradual degenerative illness, knee osteoarthritis (KOA) is characterized by high rates of impairment and prevalence. Patients' quality of life is seriously jeopardized, and healthcare systems and social advancement are continuously burdened. Because it is minimally invasive, intra-articular injection treatment is frequently used to treat KOA. Among these, ozone therapy has drawn more and more clinical interest because of its ease of use, affordability, and observable symptom relief. Its scientific application in long-term management strategies is limited, nonetheless, because the exact length of its therapeutic benefits is still unknown. Objective: This study is to integrate clinical data from various follow-up time points using systematic review and meta-analysis techniques in order to comprehensively assess the temporal efficacy of intra-articular ozone therapy in reducing symptoms among patients with KOA. In order to provide evidence-based support and decision-making references for phased and continuous clinical treatment planning, the goal is to elucidate the temporal aspects of persistent therapeutic effects. Methods: Searches were conducted in PubMed, Embase, the Cochrane Library, Web of Science, and Scopus from the inception of each database up to December 3, 2025. Two reviewers independently extracted data using the Cochrane Risk of Bias Assessment Tool and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, and assessed the quality of the evidence and the certainty of the evidence for each outcome measure. Outcomes included Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain, WOMAC stiffness, WOMAC physical function, WOMAC Total, and Visual Analog Scale (VAS) pain. For combined outcomes, standardized mean difference (SMD) and 95% confidence interval (CI) were calculated. Statistical analysis and graphing of included information were performed using Review Manager 5.4.1, Stata 15.0, and GRADEpro GDT. Results: A total of 16 randomized controlled trial (RCT) studies ( Conclusions: Intra-articular ozone therapies are effective in alleviating pain and improving joint function in patients with knee osteoarthritis in the short term (1-2 months), with effects peaking at 2 months. By 3 months, the therapeutic effect diminishes, and by 6 or 12 months, the evidence of efficacy is very weak, whereas active comparators (such as hyaluronic acid) demonstrate superior therapeutic outcomes at these time points. These findings suggest that ozone therapy may serve as a short-term treatment option but also underscore the need for placebo-controlled long-term trials and studies on repeated dosing regimens before recommending repeat injections. Systematic Review Registration: identifier CRD420251169941.

Indexed as

knee osteoarthritismeta-analysisozone therapysystematic reviewtime-course

Identifiers

PMID42389359
PMCPMC13319046

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.