Due to the extended life expectancy of the population, 50% of people over 60 years old show signs of osteoarthritis on X-rays. Among them, 35% to 50% have clinical manifestations, and over 75% of the population have symptoms of osteoarthritis, which can occur in both men and women. After the onset of the disease, there is prolonged pain and difficulty walking, seriously affecting everyone's daily life. Knee osteoarthritis is a slowly progressive bone and joint disease that damages the health of middle-aged and elderly people. Ozone has anti-inflammatory and analgesic effects. The treatment of knee osteoarthritis has been clinically applied and achieved satisfactory results.
1. Cause: The cause of OA is unknown and may be related to multiple factors such as age, genetics, trauma, and decreased estrogen levels. The essence of osteoarthritis lesions is first and foremost damage to the cartilage. The articular cartilage is incomplete, and the disease continues to progress, affecting the entire joint, leading to inflammation of the joint capsule and synovium, as well as atrophy of the muscles around the joint.
2. Diagnostic criteria: The OA classification diagnostic criteria revised by the American College of Rheumatology in 1995 showed obvious signs of OA on X-ray examination. Symptoms and signs: (1) Knee pain was present for most of the month prior to seeking medical attention. (2) There is morning stiffness, time<; 30 minutes. (3) Age>; 40 years old, with bone friction sounds. (5) Bone enlargement.
3. Treatment guidelines: The fundamental principle of treating osteoarthritis is to alleviate pain, improve joint function, and delay the progression of the disease, which means maintaining joint cartilage and delaying the process of cartilage damage, ultimately achieving the goal of improving the quality of life for patients.
4. Traditional ozone therapy for knee osteoarthritis
The usual approach is to provide education, select suitable professions that are conducive to disease recovery, choose physical therapy, weight control, training, use of assistive devices, and other methods. The commonly used medication treatment methods include administering performance reducing drugs such as acetaminophen and nonsteroidal anti-inflammatory and analgesic drugs (NSAIDs), and injecting steroid hormones into the joints of patients with severe symptoms. Those with severe symptoms need joint reorganization or joint replacement surgery. The above traditional therapies can fundamentally reduce symptoms, improve joint function, and to a certain extent improve the quality of life. However, these traditional drug treatments to some extent exacerbate cartilage damage, because simply reducing pain will cause patients to blindly increase their activity, which not only cannot delay but also accelerates the progression of the disease.
5. Ozone (O3) therapy:
1) Principle: Ozone (O3) is a strong oxidant composed of three oxygen atoms, with a half-life of about 20 minutes at room temperature. It is easily differentiated and soluble in water, and can only be produced on-site. It is a light blue gas with a special odor that is more significant than O2. This effect is completed in an instant without lasting residue. The principle of using medical ozone to treat joint diseases may be that when ozone is injected into the joint cavity, it immediately reacts with biochemical molecules (such as proteins) in the joint synovial fluid, producing ROS, LOPs（lipid oxidation productions）， Resulting in the following effects: (1) Inactivating or suppressing proteolytic enzymes and inflammatory cytokines, reducing inflammation. (2) Inducing the occurrence of antioxidant enzymes: superoxide dismutase, glutathione superoxide dismutase. Increase the composition of interstitial cells and articular cartilage. Affects the proliferation of cartilage and fibroblasts, and has a certain corrective effect. (3) The release of bradykinin and the composition of inflammatory mediators PGs can alleviate pain (affecting cytokine release to neutralize some inflammatory mediators, such as IL-1, IL-12, IL-15, TNF, to reduce inflammation). (4) Promote the release of immune suppressive factors (such as TGF - β 1, IL-10) to suppress immune responses. (5) O3 has the effect of oxidizing proteoglycans, and proteoglycans with positive charges can attract negative charges and have the characteristic of adding positive charges. (6) Analgesic effect: After injection, it directly acts on the nerve endings and suppresses the release of intermediate neurons and substances such as enkephalins, thereby achieving the analgesic effect.
(2) Procedure: The patient is in a supine position with a knee joint flexion of about 70 ° -90 °. After disinfection, 2% lidocaine is used to inject into the pain points first. Under local anesthesia, a 7 gauge 10cm long needle is used to puncture the joint cavity from the intersection point of the horizontal line of the upper edge of the patella and the vertical line of the outer edge of the patella. The needle is inserted inward and downward through the puncture point; The needle can also be injected through any side of the patellar ligament close to the lower direction of the patella, and the injection in the joint cavity is from the medical ozone therapeutic instrument. The instrument uses medical pure oxygen as the material, and connects it with the medical oxygen bottle. Before the injection, the output of medical pure oxygen is adjusted to 4-5 L/min, and the output concentration of O3 is adjusted to 40-50 μ g/ml. After turning on the power switch for about 15 seconds, the odor of ozone can be smelled, and the injection device can be used to collect O3. Extract 40 ml of medical ozone with a concentration of 40-50 μ g/ml. After the injection, instruct the patient to maintain joint relaxation, rest for about 15 minutes, and then move the joints slightly. Mild cases should be treated once, and severe cases can receive another injection of 20 ml of medical ozone with a concentration of 40 μ g/ml into the joint cavity one week later. When there is joint effusion, first aspirate the effusion. Carefully inquire about medical history before treatment, for those whose physical conditions do not allow or who have mental abnormalities; It is contraindicated for patients with ozone allergy, hyperthyroidism, and G-6-PD deficiency.

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