Vol. 7, Issue 1, Part A (2025)

Background: Osteoarthritis (OA) is a heterogenic group of different etiology disorders with similar morphological, biological, and clinical outcomes and manifestations. We aimed to compare the intraarticular ozone injection, prolotherapy or dexmedetomidine effectiveness in knee OA (KOA) patients. 
Methods: This randomized prospective study was carried out on 60 cases aged from 30 to 65 years old, both sexes, diagnosed with stage 1-3 osteoarthritis according to the Kellgren-Lawrence Classification System (K-L). Cases were randomly allocated using computer generated randomization tables. into three equal groups: Group O received intra-articular (IA) ozone injection, group P received IA dextrose prolotherapy injection, group D received IA dexmedetomidine injection. 
Results: A significant difference was indicated between the three groups with marked decrease of numerical rating scales, Western Ontario Mac Master OA Index, tumor necrosis factor (TNFα), analgesic requirement markedly decreased in Group O, group P more than group D (P<0.001, <0.001, 0.013, respectively). There was statistically significant difference between the three groups regarding AROM, extension, K-L (P=0.039, 0.019, 0.001, respectively) as knee flexion enhanced in group O and group P than group D.
Conclusions: We compared the IA ozone injection, prolotherapy or dexmedetomidine effectiveness in KOA patients. Analges in each group and according to TNF-α. Ozon and prolotherapy may yield satisfactory results more than dexmedetomidine in KOA.