Discussion
inflammation, deformityOsteoarthritis, pain, KOA
INFLAMMATION, DEGENERATIVE, DISEASE, DYSFUNCTION, HYPERTROPHIC ARTHRITIS, STASIS, INFLAMMATORY RESPONSE
KOA, also known as degenerative, hyperplastic or hypertrophic arthritis, is common among middle-aged and elderly women6. With further development, joint deformity and dysfunction occur in severe casesIn the present study, there were no significant differences in general data between the two groups (P>0.05). Before treatment, VAS score and HSS score had no significant differences between the two groups (P>0.05). After treatment, the VAS score significantly declined and the HSS score significantly rose in both groups (P<0.05). It can be seen that both intra-articular injection of sodium hyaluronate and ozone therapy can greatly reduce the pain and ameliorate the knee joint function of KOA patients. Observation group had a significantly lower VAS score and a significantly higher HSS score than control group after treatment (P<0.05), suggesting that ozone combined with intra-articular injection of sodium hyaluronate has a better effect than injection of sodium hyaluronate alone. The total response rate after treatment in observation group was higher than that in control group (P<0.05), further confirming that ozone combined with sodium hyaluronate has a more significant effect. It has been proved that the inflammatory response is the main pathological feature of KOA, and inflammatory factors are the main factors destroying articular cartilage and inducing pain, whose levels, therefore, play an important role in the progression of disease. VEGF is able to increase the permeability of micro vessels and venules, and promote the formation of synovial inflammatory tissues and angiogenesis, thereby inducing inflammation and causing joint deformityOsteoarthritis patients have increased blood viscosity and weakened erythrocyte deformability, and such a blood stasis state may enhance the progression of diseaseIn conclusion, ozone combined with intra-articular injection of sodium hyaluronate has a more significant therapeutic effect on KOA than injection of sodium hyaluronate alone, which can effectively lower the levels of inflammatory factors (VEGF, TNF-α, IL-1β, IL-6, hs-CRP and MMP-13), alleviate the inflammatory response and improve hemorheology, thereby reducing the pain and improving the knee joint function of patients. Regardless, this study is still limited. This is a single-centre study with a small sample size, so the results may have bias. Multicentre studies with larger sample sizes are ongoing in our group.