Rectal Ozone Insufflation Combined with Intra-Articular Prolozone for The Management of Post-Covid-19 Hip Osteonecrosis

Saeed AM, Khattab MA and Selim N

Published on: 2024-09-26

Abstract

Background: The coronavirus disease pandemic has leaded to numerous long-term complications, including the less recognized but serious condition of hip osteonecrosis in post-recovery patients. Ozone therapy, recognized for regenerative and its anti-inflammatory properties, has shown promise in managing musculoskeletal disorders.

Aim: This research objected to assess the safety and effectiveness of combining rectal ozone insufflation with intra-articular prolozone therapy in managing post-COVID-19 hip osteonecrosis, with the goal of reducing pain, improving joint function, and delaying the need for surgical intervention.

Patients and Methods: This prospective cohort research involved 50 cases diagnosed with post- coronavirus disease hip osteonecrosis. All participants underwent combined rectal ozone insufflation and intra-articular prolozone therapy. Primary outcomes were joint function improvement, measured by the Harris Hip Score and Ficat & Arlet classification, while pain levels were assessed using the Visual Analog Scale. Data have been obtained at baseline and monitoring intervals up to 6 months.

Results: The study included patients aged 21 to 65 years (mean age: 37.3 years), with 54% males and 46% females; 74% had pre-existing comorbidities. Significant improvements in hip osteonecrosis and pain reduction were demonstrated over the 6-month monitoring duration. The mean Ficat & Arlet score reduced between 2.4 and 2.3 on the right side and from 2.6 to 2.2 on the left side. Pain levels, measured by the Visual Analog Scale (VAS), significantly reduced from 7.6 pre-procedure to 3.4 at six months. The Harris Hip Score increased from a baseline mean of 67.4 to 82.8 after six months, indicating improved joint function.

Conclusion: Our study supports the effectiveness and safety of combining rectal ozone insufflation with intra-articular prolozone therapy in managing post-COVID-19 hip osteonecrosis, demonstrating significant improvements in pain, joint function, and overall patient outcomes.