Efficacy of ozone therapy in the treatment of frozen shoulder in rats: An experimental study
Ekin Kaya Simsek1
, Duygu Turkbey Simsek2, Deniz Mert Ayan1, Coskun Araz3, Bahtiyar Haberal1
1Department of Orthopedics and Traumatology, Başkent University Faculty of Medicine, Ankara, Türkiye
2Department of Pathology, Gülhane Training and Research Hospital, Ankara, Türkiye
3Department of Anesthesiology and Reanimation, Başkent University Faculty of Medicine, Ankara, Türkiye
Keywords: Frozen shoulder, corticosteroids, fibrosis, inflammation, ozone therapy.
Abstract
Objectives: This study aims to explore the therapeutic effects of medical ozone therapy on the frozen shoulder (FS) model and compares it with traditional corticosteroid treatments in rats.
Materials and methods: A total of 30 Sprague-Dawley rats aged 18 to 20 months weighing between 400 to 450 g were included in the study. The rats were randomly divided into three equal groups: a control group (C, n=10, FS model only), a corticosteroid treatment group (CST, n=10, FS model + intraarticular 0.5 mg/kg betamethasone), and an ozone treatment group (OT, n=10, FS model + intraarticular 1 mg/kg ozone). Frozen shoulder was induced via surgical immobilization, and treatments were administered intraarticularly. Outcomes were measured through histopathological and functional assessments.
Results: The CST and OT significantly reduced inflammation (p<0.001), capillary proliferation (p<0.001), fibroblastic proliferation (p=0.002), collagen type 3 staining (p=0.022), and mean capsular thickness (p<0.001), while improving the range of motion in all directions compared to the control group. Ozone therapy showed a comparable reduction in fibrosis and improvement in joint mobility to CST (p=0.001).
Conclusion: Ozone therapy effectively reduces fibrosis and improves mobility in an FS rat model, presenting a promising alternative to corticosteroids. However, further studies are still needed to elucidate the molecular mechanisms and optimize treatment protocols, underscoring the potential for future discoveries in this area.
Citation: Kaya Simsek E, Turkbey Simsek D, Ayan DM, Araz C, Haberal B. Efficacy of ozone therapy in the treatment of frozen shoulder in rats: An experimental study. Jt Dis Relat Surg 2025;36(2):272-282. doi: 10.52312/jdrs.2025.2055.
Idea/concept: E.K.Ş., B.H.; Design: E.K.Ş., C.A.; Control/supervision, literature review: B.H.; Data collection and/or processing: E.K.Ş., D.T.Ş.; Analysis and/or interpretation: D.M.A., D.T.Ş.; Writing the article: E.K.Ş.; Critical review: B.H., C.A.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
The data that support the findings of this study are available from the corresponding author upon reasonable request.