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Hyperbaric oxygen therapy modulates serum OPG/RANKL in femoral head necrosis patients
Authors:Giuliano Vezzani  Silvia Quartesan  Pasqua Cancellara  Enrico Camporesi  Devanand Mangar  Thomas Bernasek
Affiliation:1. Department of Biomedical Sciences, Physiological Laboratory, University of Padova, Padova, Italy;2. Anesthesia, Tampa General Hospital;3. TEAM Health Anesthesia Research Institute, Tampa, FL, USA;4. Florida Orthopedic Institute, Tampa, FL, USA
Abstract:Hyperbaric oxygen therapy (HBOT) has beneficial effects on avascular necrosis of femoral head (ANFH), but its mechanism of action is still unclear. We investigated if HBOT upregulates serum osteoprotegerin (OPG) and/or inhibits osteoclast activation. 23 patients with unilateral ANFH at stage I, II and III consented to the study: the patients received standard HBOT. Serum OPG levels were obtained at the beginning of HBOT (T0), after 15 sessions (T1), 30 sessions (T2), after a 30-day break (T3), and after 60 sessions (T4). Magnetic resonance imaging (MRI) was obtained at T0 and about one year from the end of HBO treatments. Lesion size was compared between pre- and post-HBOT. 19 patients completed the study. HBOT reduced pain symptoms in all patients. HBOT significantly reduced lesion size in all stage I and II patients and in 2 of 11 stage III patients. HBOT increased serum OPG levels but receptor activator of nuclear factor kappa-B ligand (RANKL) levels did not change.
Keywords:Avascular necrosis of femoral head  bone remodeling  hyperbaric oxygen therapy  serum osteoprotegerin  serum receptor activator of NF-kB Ligand
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