Role of Topical Phytotherapy on the Risk Factor of Elevated Level of Serum Aldolase-A in Knee-Osteoarthritis: Part II. A Systematic Meta-Analysis

ABSTRACT

Background: Knee-osteoarthritis (KOA) is a degenerative joint disease. Elevated level of aldolase-A (AldoA) in serum indicates skeletal muscle damage in KOA. The present study was attempted to normalize the elevated level of AldoA by topical phytotherapeutic protocol correlated with leg-anatomy, body mass index (BMI), pain, stiffness and physical function and the Kellgren-Lawrence (KL) grading-systems. Methods: Baseline data from144 patients (61.80% females) with KOA aged 40-75 years old were recruited in this cross-sectional study. Bilateral anatomy of  legs including 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, angles of straight leg raising, flexion and extension in different positions and BMI were measured using appropriate instruments. AldoA was estimated in serum. The KL grading-system of radiographic KOA and overall pain under VAS and pain, stiffness and physical function under WOMAC index were also evaluated. All the parameters were compared between the baseline and post-42 days of treatment. Results: The anatomical features were observed symmetry in both legs at the end of the 42nd session with highly statistical significance (P<0.0001). The significant changes were also observed in VAS (P<0.00001), WOMAC index (P<0.001), AldoA level (P<0.0001), BMI (P<0.0001) and improvement of KL grading systems was noted for both knee-joints. Conclusion: The functional improvements of skeletal muscles confirmed with normalization of elevated AldoA level, leg-anatomical measurements, BMI, VAS, WOMAC index and KL grading systems of radiographic KOA due to the effects of phytochemicals present in phytoextracts.