title: Effect of mud compress therapy on cartilage destruction detected by CTX-II in patients with knee osteoarthritis.
abstract: OBJECTIVE
  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).
  
  
  METHODS
  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 versus 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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Denizli Governmental Hospital, Clinic of Physical Medicine and Rehabilitation, Denizli, Turkey.
authors.forename: Gonca Odemis
authors.initials: GO
authors.lastname: Gungen
authors.affiliation: Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Pamukkale, Denizli, Turkey.
authors.forename: Fusun
authors.initials: F
authors.lastname: Ardic
authors.affiliation: Department of Biochemistry, Faculty of Medicine, University of Pamukkale, Denizli, Turkey.
authors.forename: Gulin
authors.initials: G
authors.lastname: Findikoglu
authors.affiliation: Department of Biochemistry, Faculty of Medicine, University of Pamukkale, Denizli, Turkey.
authors.forename: Simin
authors.initials: S
authors.lastname: Rota
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000652:urine; D002358:Cartilage, Articular / Q000503:physiopathology*; D024043:Collagen Type II / Q000652:urine*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009094:Mud Therapy; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000628:therapy*; D010446:Peptide Fragments / Q000652:urine*; D064232:Visual Analog Scale
chemical_list: D015415:Biomarkers; C000590554:C-terminal cross-linking telopeptide of type II collagen, human; D024043:Collagen Type II; D010446:Peptide Fragments
keywords: Biomarker; CTX-II; balneotherapy; bone; spa; subchondral