Impact of Topical Phytotherapeutic Effects on Elevated Level of Serum Creatine Kinase- Muscle as Risk Factor of muscular degeneration in Knee-Osteoarthritis: Part III. A Systematic Meta-Analysis

ABSTRACT

Background: The knee-osteoarthritis (KOA) is a risk for muscular degeneration by the elevation of creatine kinase-muscle (CK-MM). The present study was aiming to normalize the elevated level of CK-MM by topical phytotherapeutic protocol correlated with anatomical measurements, the Kellgren- Lawrence (KL) grading systems of radiographic KOA, body mass index (BMI), overall improvement of pain under visual analogue scale (VAS) and pain, stiffness and physical function under WOMAC index. Methods: Baseline data from 108 patients (66.67 % females) with KOA aged 40-75 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 of thighs and calves, angles of straight leg raising, flexion and extension in different positions and BMI were measured using appropriate instruments. The elevated level of CK-MM, scored KL grading system and pain under VAS and WOMAC index were also evaluated at the baseline and after 42 days of treatment. Results: All the bilateral leg anatomical measurements were symmetry at the end of the 42nd session (P<0.0001). The significant changes were observed in VAS (P<0.00001), WOMAC index (P<0.0001), CK-MM level (P<0.0001), BMI (P<0.0001) and improvement of KL grading scores. Conclusions: The improvements of damaged leg muscles due to muscular dystrophy, connective tissue damage etc. confirmed with normalization of elevated serum CK-MM level, above mentioned anatomical measurements, BMI, VAS, WOMAC index and KL grading systems may be synergistic effect of phytochemicals during specific phytotherapeutic treatment protocol.