showed a trendP < 0.01
Results ( Figures 5 – 7 ): For pain relief, the ozone group demonstrated significantly greater efficacy than the control group [SMD = − 1.39, 95% CI (−1.96, −0.81), P < 0.01]; For improving physical function, the ozone group showed significantly greater improvement than the control group [SMD = − 1.27, 95% CI (−2.06, −0.49), P < 0.01]; Regarding stiffness improvement, the meta-analysis showed a trend toward reduced WOMAC stiffness scores with ozone therapy, but its 95% confidence interval spanned the non-difference line [SMD = − 0.47, 95% CI (−1.16, 0.21), P < 0.01], indicating high statistical uncertainty regarding this effect.