When applying this therapy, we are really inducing a controlled and harmless “micro-oxidation” that will produce a modulation of the cellular antioxidant system and the inflammation system. Ozone reacts with interstitial fluids producing hydrogen peroxide (H2O2), aldehydes, and lipid oxidation products (LOPs). These substances induce activation of the nuclear factor erythroid 2-related factor 2 (NRF2) pathway that will induce an increase in antioxidant systems (ARE), such as superoxide dismutase (SOD), catalase (CAT), reduced glutathione (GSH), glutathione peroxidase (GSH-Px), glutathione s-tranferase (GSTr), hem-oxygenase-1 (HO-1), reduced nicotinamide adenine dinucleotide phosphate (NADPH), NADPH quinone oxidoreductase 1 (NQO1) and heat shock protein-70 (HSP70; Baeza et al., 2015). This NRF2 activation induces a decrease in the nuclear factor kappa beta (NFKβ) pathway activity, inducing an anti-inflammatory effect [decrease of interleukynes 1,2,6,7 and tumor necrosis factor alpha (TNFα) and increase of interlukynes 4, 10, 13 and transforming growing factor beta (TGFβ)] In the injected tissues, medical ozone inactivates proteolytic enzymes through the inhibition of the NFKβ pathway. At the same time, there is a proliferation of fibroblasts and chondrocytes, favoring cartilaginous regeneration