title: Assessment of pulsed electromagnetic field therapy with Serum YKL-40 and ultrasonography in patients with knee osteoarthritis.
abstract: OBJECTIVE
  The use of biomarkers of osteoarthritis (OA) have potential for early diagnosis, evaluation of disease severity and monitoring treatment. Serum and synovial fluid YKL-40 levels are increased in severe knee OA. Pulsed electromagnetic field (PEMF) therapy is a novel treatment method for OA. However, studies evaluating the PEMF therapy in treatment of knee OA revealed conflicting results. This study was conducted to objectively assess the effect of PEMF therapy in patients with knee OA, by using ultrasonographic measurements and a novel biomarker, YKL-40.
  
  
  METHODS
  Forty patients were randomized into two treatment groups. Both groups received conventional physical therapy, while Group 1 received additional PEMF therapy. The patients were asked to rate their pain on a visual analogue scale (VAS) and complete a Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. Serum YKL-40 levels were measured, and knee effusion and cartilage degeneration level were evaluated with ultrasonography before and after treatment.
  
  
  RESULTS
  Pre-treatment YKL-40 level was correlated with WOMAC pain subscale (P = 0.032, r = 0.339). VAS and WOMAC scores significantly improved in both treatment groups (P < 0.05). The effusion in the right knee significantly decreased in Group 1. The change in YKL-40 level was not correlated with the change in VAS, WOMAC scores and knee effusion.
  
  
  CONCLUSIONS
  This study revealed that adjuvant PEMF therapy has no additional effect on pain in patients with knee OA. Serum YKL-40 level seems to be unuseful for monitoring the treatment in knee OA.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Ümit
authors.initials: Ü
authors.lastname: Dündar
authors.affiliation: Department of Microbiology, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Gülşah
authors.initials: G
authors.lastname: Aşık
authors.affiliation: Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Alper Murat
authors.initials: AM
authors.lastname: Ulaşlı
authors.affiliation: Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Şükrü
authors.initials: Ş
authors.lastname: Sınıcı
authors.affiliation: Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Fatima
authors.initials: F
authors.lastname: Yaman
authors.affiliation: Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Solak
authors.affiliation: Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Toktaş
authors.affiliation: Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey.
authors.forename: Selma
authors.initials: S
authors.lastname: Eroğlu
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D000071451:Chitinase-3-Like Protein 1 / Q000097:blood*; D003131:Combined Modality Therapy; D004574:Electromagnetic Fields / Q000009:adverse effects; D005260:Female; D006801:Humans; D055909:Magnetic Field Therapy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy*; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D011237:Predictive Value of Tests; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; C084533:CHI3L1 protein, human; D000071451:Chitinase-3-Like Protein 1
keywords: biomarker; knee; magnetic field; osteoarthritis; ultrasonography YKL-40