Moreover, intra-articular ozone therapy may be used either in combination with another therapy or alone for knee osteoarthritic subjects and it might delay the partial or total replacement of the knee in patients suffering from primary or secondary osteoarthritis.

As per the findings of a recently conducted study by the scientists of Ilam University of Medical Sciences, and Qazvin University of Medical Science, intra-articular injection of ozone gas provides effective relief from knee osteoarthritis-associated chronic pain. There is evidence regarding the efficacy of ozone gas but whether the gas can be medically beneficial in KOA pain is still under evaluation. 

Medline, Scopus, Pubmed Central, Embase, Google Scholar, and Pubmed were evaluated until July 2018, and ten studies were selected after fulfilling the inclusion and exclusion criteria for meta-analysis.

High heterogeneity was seen in the chosen studies; therefore, the random-effects model was adopted for SMD estimation. The weighted pooled effect size for the impact of intra-articular ozone therapy for pain reduction as per the primary analysis for the main hypothesis was found to be SMD= -28.551. Further, the P-value observed by the z-test for the significance of the combined SMD was 0.000, and therefore, it was undoubtedly deemed statistically significant. These findings explain a considerable role of ozone gas in the management of KOA.