Efficacy of Combined Platelet-Rich Plasma and Ozone Injections in Advanced Knee Osteoarthritis: A Retrospective Clinical Study

Rıdvan Işık; Emre Uzun; Muhammed Zahid Şahin; Kemal Nas

doi:10.70058/cjm.1949110

Efficacy of Combined Platelet-Rich Plasma and Ozone Injections in Advanced Knee Osteoarthritis: A Retrospective Clinical Study

Abstract

Objective: Knee osteoarthritis (KOA) is a major cause of pain and disability, particularly in the advanced stages, where treatment options are limited. Platelet-rich plasma (PRP) and ozone therapy have individually demonstrated beneficial effects. However, evidence regarding their combined use, especially in severe KOA, remains scarce. Therefore, with this study, we aimed to evaluate the efficacy of combined intra-articular PRP and ozone injections in patients with advanced knee osteoarthritis.

Methods: This study included 61 patients with advanced KOA who were treated with three ultrasound-guided intraarticular injections of PRP, followed by ozone at two-week intervals. Pain and function were assessed using the Numerical Rating Scale (NRS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at baseline, 1
month, and 3 months.

Results: Significant improvements were observed in both pain and functional scores over time (P < 0.001). The mean NRS decreased from 7.70 ± 1.37 at baseline to 4.54 ± 1.15 at 1 month, increasing to 6.33 ± 1.29 at 3 months. WOMAC scores improved from 73.61 ± 12.64 to 54.44 ± 11.67 at 1 month but returned to near baseline (73.21 ± 12.33) at 3 months. At 1 month, 90.2% of patients achieved ≥30% pain reduction, decreasing to 9.8% at 3 months.

Conclusion: Combined PRP and ozone therapy provides substantial short-term improvements in advanced KOA in terms of pain and function. Yet, these benefits decrease notably within 3 months. This treatment may be considered a short-term or adjunctive option rather than a durable, long-term solution.

Keywords

Ethical Statement

This study was approved by the local Ethics Committee of Sakarya University Health Sciences Scientific Research Ethics Committee (Approval number: E-43012747-050.04-481705-383, Date: 14/05/2025). The study was conducted in accordance with the principles of the Declaration of Helsinki. Due to the retrospective nature of the study, the requirement for informed consent was waived.

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Details

Primary Language

English

Subjects

Orthopaedics

Journal Section

Research Article

Authors

Rıdvan Işık
0000-0002-5715-2844
Türkiye

Emre Uzun
0000-0002-4394-1906
Türkiye

Muhammed Zahid Şahin ^*
0009-0004-8639-2742
Türkiye

Kemal Nas
0000-0002-5845-0851
Türkiye

Early Pub Date

July 12, 2026

Publication Date

-

Submission Date

May 11, 2026

Acceptance Date

June 29, 2026

Published in Issue

Year 2026 Number: Advanced Online Publication

DOI

https://doi.org/10.70058/cjm.1949110

IZ

https://izlik.org/JA98NS65JE

Cite

RIS / Bibtex

APA

Işık, R., Uzun, E., Şahin, M. Z., & Nas, K. (2026). Efficacy of Combined Platelet-Rich Plasma and Ozone Injections in Advanced Knee Osteoarthritis: A Retrospective Clinical Study. Cerasus Journal of Medicine, Advanced Online Publication. https://doi.org/10.70058/cjm.1949110

AMA

1.Işık R, Uzun E, Şahin MZ, Nas K. Efficacy of Combined Platelet-Rich Plasma and Ozone Injections in Advanced Knee Osteoarthritis: A Retrospective Clinical Study. Cerasus J Med. 2026;(Advanced Online Publication). doi:10.70058/cjm.1949110

Chicago

Işık, Rıdvan, Emre Uzun, Muhammed Zahid Şahin, and Kemal Nas. 2026. “Efficacy of Combined Platelet-Rich Plasma and Ozone Injections in Advanced Knee Osteoarthritis: A Retrospective Clinical Study”. Cerasus Journal of Medicine, no. Advanced Online Publication. https://doi.org/10.70058/cjm.1949110.

EndNote

Işık R, Uzun E, Şahin MZ, Nas K (July 1, 2026) Efficacy of Combined Platelet-Rich Plasma and Ozone Injections in Advanced Knee Osteoarthritis: A Retrospective Clinical Study. Cerasus Journal of Medicine Advanced Online Publication

IEEE

[1]R. Işık, E. Uzun, M. Z. Şahin, and K. Nas, “Efficacy of Combined Platelet-Rich Plasma and Ozone Injections in Advanced Knee Osteoarthritis: A Retrospective Clinical Study”, Cerasus J Med, no. Advanced Online Publication, July 2026, doi: 10.70058/cjm.1949110.

ISNAD

Işık, Rıdvan - Uzun, Emre - Şahin, Muhammed Zahid - Nas, Kemal. “Efficacy of Combined Platelet-Rich Plasma and Ozone Injections in Advanced Knee Osteoarthritis: A Retrospective Clinical Study”. Cerasus Journal of Medicine. Advanced Online Publication (July 1, 2026). https://doi.org/10.70058/cjm.1949110.

JAMA

1.Işık R, Uzun E, Şahin MZ, Nas K. Efficacy of Combined Platelet-Rich Plasma and Ozone Injections in Advanced Knee Osteoarthritis: A Retrospective Clinical Study. Cerasus J Med. 2026. doi:10.70058/cjm.1949110.

MLA

Işık, Rıdvan, et al. “Efficacy of Combined Platelet-Rich Plasma and Ozone Injections in Advanced Knee Osteoarthritis: A Retrospective Clinical Study”. Cerasus Journal of Medicine, no. Advanced Online Publication, July 2026, doi:10.70058/cjm.1949110.

Vancouver

1.Rıdvan Işık, Emre Uzun, Muhammed Zahid Şahin, Kemal Nas. Efficacy of Combined Platelet-Rich Plasma and Ozone Injections in Advanced Knee Osteoarthritis: A Retrospective Clinical Study. Cerasus J Med. 2026 Jul. 1;(Advanced Online Publication). doi:10.70058/cjm.1949110