Effect of mud compress therapy on cartilage destruction detected by CTX-II in patients with knee osteoarthritis

Authors: Gungen GO (1) , Ardic F (2) , Findinkoglu G (3) , Rota S (3)
(1) Denizli Governmental Hospital, Clinic of Physical Medicine and Rehabilitation (2) Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Pamukkale University (3) Department of Biochemistry, Faculty of Medicine, Pamukkale University
Source: J Back Musculoskelet Rehabil. 2015 Sep 6
DOI: 10.3233/BMR-150629 Publication date: Sept. 6, 2015 E-Publication date: Not specified Availability: abstract Copyright: Not specified
Language: English Countries: Not specified Location: Not specified Correspondence address: Gonca Odemis Gungen,
Physical Medicine and Rehabilitation, Denizli Governmental Hospital, Denizli, Turkey.
Tel.: +90 5054558945; Fax: +90 258 211 81 29


Article abstract


The aim of this study is to investigate the effect of mud compress (MC) therapy compared to hot pack (HP) therapy on cartilage destruction and subchondral bone alterations detected by urine levels of C telopeptide fragment of collagen type-II (uCTX-II) in patients with knee osteoarthritis (OA).


Fifty-nine patients between 49-74 years of age with bilateral knee OA divided into 2 groups. Twenty-five patients (16 females, 9 males) and 34 patients (22 females, 13 males) were given HP and local natural organic and mineral-rich MC therapy respectively for 2 weeks as a total of 12 sessions. uCTX-II, Visual Analog Scale (VAS), 15 m walking time, Western Ontario and McMaster Universities multifunctional (WOMAC) index were measured at baseline, after-treatment and 3 months after treatment.


uCTX-II level did not show any difference between the two groups, however it decreased significantly in MC and HP groups 3 months after treatment (p< 0.017). WOMAC stiffness sore was significantly lower in MC group 3 months after treatment (p< 0.05). Both MC and HP therapies lowered VAS, WOMAC total and subscores significantly up to 3 months (p< 0.017).


HP and MC therapies for OA of knee are not superior to one another with respect to the level of uCTX-II. MC may probably decrease the ongoing cartilage destruction and related subchonral bone interactions earlier compared to HP treatment in patients with knee OA as evidenced by decreased uCTX-II levels after-treatment.

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