400 Section - The Therapeutic Role of Oxygen-Ozone Therapy in Hip Osteoarthritis: A Scoping Review

Osteoarthritis (OA) of the hip is a degenerative joint disease that leads to chronic pain and disability. Conventional treatments include pharmacological management, intra-articular steroid injections, and surgical interventions such as total hip arthroplasty. However, alternative regenerative therapies, including oxygen-ozone therapy combined with hyaluronic acid, have emerged as potential treatment options. This scoping review aims to map the existing literature on the efficacy of intra-articular oxygen-ozone therapy in managing hip OA.

Design: A systematic literature search was conducted in PubMed, Scopus, and Embase to identify randomized controlled trials (RCTs) and observational studies published between 2000 and 2025 that evaluated the effects of intra-articular oxygen-ozone therapy, alone or in combination with hyaluronic acid, on hip OA. Two studies were found and data extraction involved clinical outcomes of pain relief, functional improvement, and delay of surgical intervention were evaluated.

Results:

Both studies demonstrated results using the standardized outcome measures. In the first study (10 patients receiving oxygen-ozone plus hyaluronic acid), VAS pain scores decreased nearly to zero and HHS improved by approximately 30% at one month. In the second retrospective study (53 patients receiving ozone therapy or intra-articular corticosteroids), patients treated with ozone therapy showed significant reductions in VAS pain and in HHS, particularly in early-stage OA (p < 0.001). Analgesic use decreased in both studies, with no significant differences between ozone and steroid treatments in longer-term outcomes. These studies indicate oxygen-ozone therapy provides meaningful clinical benefit comparable to steroids, especially in early hip OA, though further trials are needed to validate long-term efficacy and optimal dosing.

Conclusion:

Oxygen-ozone therapy presents a promising alternative for the management of hip OA, particularly in early to moderate stages of the disease. While preliminary evidence supports its efficacy in pain relief and functional improvement, protocols and RCTs are needed to establish its long-term benefits and optimal dosing regimens.