Efficacy of Phytotherapeutic Protocol for the Risk Factor of Elevated Level of Serum C-Reactive Protein in Knee-Osteoarthritis: Part I. A Systematic Meta - Analysis

ABSTRACT

Background: Knee-osteoarthritis (KOA) is a common disease worldwide. C-reactive protein (CRP) in serum is a marker enzyme for inflammation and elevated in KOA. The present study was aiming to normalize the elevated level of CRP by topical phytotherapeutic protocol correlated with anatomical measurements, body mass index and radiological images in KOA. Materials & Methods: Baseline data from153 patients (101 females and 52 males) with KOA aged 40-70 years old were recruited in this cross-sectional study. Bilateral anatomical measurements included the gap at the knee between the short head of the biceps femoris and the surface of the bed, diameter of muscles 4cm above and below the patella and calf, and flexion and extension in supine, prone and standing positions and body mass index (BMI) were measured using appropriate instruments. The elevated level of serum CRP and pain under visual analogue scale (VAS) and WOMAC osteoarthritis index were also evaluated at the baseline and after 42nd sessions by topically applied specialized phytotherapeutic treatment protocol. Results: All the bilateral leg anatomical measurements were symmetry at the end of the 42nd sessions (P<0.0001). The significant changes were observed in pain under VAS (P<0.0001) and WOMAC scales (P<0.0001), CRP level (P<0.0001) and BMI (P<0.0001). The radiological features of the knee-joints were also revealed the improvement in KOA.  Conclusion: The improvements of inflammation and normalization of elevated serum CRP level confirmed by anatomical measurements, BMI, VAS and WOMAC index and radiological images in KOA by topical phytotherapy. This study revealed that combinations of phytochemicals during topical application may be synergistic effect.