The Effectiveness of Ozonated Platelet Rich Plasma& Exercise as Pain Management for Baker’s Cyst Associated with Knee Joint Osteoarthritis

Abstract

Objectives
Baker’s cyst is the most common cystic lesion around the knee joint, particularly prevalent in individuals with knee osteoarthritis, with an incidence rate reported between 10% and 41%. This study aimed to evaluate the clinical effectiveness of intralesional Ozonated Platelet-Rich Plasma (PRP) injections combined with exercise in managing Baker’s cyst associated with knee osteoarthritis.

Methods
This retrospective study included 24 patients (17 females and 7 males) treated at a private clinic in Kirkuk over an 18-month period (July 1, 2018 – December 31, 2019). All patients received a comprehensive clinical, radiological, and ultrasound assessment. PRP was prepared from autologous blood using a two-step centrifugation process and activated with ozone using a Longevity Resources EXT50 Ozone Generator. Following cyst aspiration, the first Ozonated PRP injection was administered under ultrasound guidance. Subsequent intra-cystic and intra-articular PRP injections were given every 4 weeks for four more sessions. Each intra-articular injection was accompanied by periarticular subcutaneous ozone infiltration. Patients also performed quadriceps-strengthening and calf-stretching exercises beginning three days after the first injection.

Results
The mean patient age was 59 ± 8 years, with the majority aged between 50–59 years (n = 12, 50%) and 60–69 years (n = 7, 29%). A total of 21 patients (87.5%) demonstrated good to excellent clinical improvement in terms of pain relief and functional recovery following the treatment regimen.

Conclusion
Intralesional and intra-articular Ozonated PRP injections, combined with a structured exercise program and adjunctive ozone therapy, appear to be a safe and effective approach for managing Baker’s cyst associated with knee osteoarthritis.