Treatment of KNEE OSTEOARTHRITIS in Spa Health resorts: where do we stand?
Osteoarthrosis (OA) includes degenerative joint disorders that affect articular cartilage in the first instance, followed by changes of all components of the joint. The disease is detected in a proportion of 33% by X-ray in patients aged over 60 years. Knee OA (KOA) ranks first among chronic diseases from the point of view of patient disability. This article is a review of guidelines and articles regarding arthrosis, balneotherapy, and balneotherapy in KOA treatment. These were accessed on the Pubmed site in the period March-April 2015. The components of balneo-therapy to which the selected articles refer include mud packs, mineral waters, climate change. These are evaluated in association or in comparison with other methods used in the rehabilitation specialty area for the treatment of KOA: kinesitherapy, intra-articular infiltrations, hydrothermotherapy. The changes induced by these therapies on clinical evolution (pain relief, tenderness, functionality, quality of life, depression symptoms) or certain serum parameters (biomarkers of oxidative stress, inflammation and cartilage destruction, vitamin D and other serum metabolites) were recorded. The results of our review are consistent with the studies focused on spa modalities in all types of OA. All these data helped defining the role of balneotherapy as part of the rehabilitation program for the treatment of KOA, through the benefits specific to it. Conclusion: Balneotherapy has beneficial effects on patients with KOA, both clinically and serologic improvements. Further studies are needed to quantify these effects using KOA specific markers, to establish a hierarchy of balneotherapy methods based on their effects on KOA, as well as to refine indications depending on the stage of the disease.