Role of joint molecular markers in assessing physical therapy modalities in traumatic knee effusion

ABSTRACT

To study the role of joint molecular markers in assessing physical therapy modalities in traumatic knee effusion, 60 athletes, 36 males and 24 females, aged 17-24 y with a mean age of 2l +/- 1.8 y with acute knee injury [ACL and MEN] associated with marked knee effusion. All subjects were subjected to diagnostic arthroscopy, pre- and post physical therapy program knee aspiration. Subjects are classified into three groups, each group consisted of 20 subjects, 8 female athletes and 12 male athletes. All participants are subjected to routine physical therapy [PT] program of post-traumatic knee synovitis, group one received only the routine PT program, group two received beside routine PT program a pulsed ultrasonic treatment, group three received routine PT program and laser treatment. Concentrations of proteoglycan [PGS] cartilage oligomatric protein [COMP], bone sialoprotein [BSP], interlukin-l beta [IL-1 beta], turmor necrosis factor-alpha [TNF-alpha] and interlukin-6 [IL-6] were measured in synovial fluid [SF] of all patient for the pre- and post PT program. Total PGS was measured using a dyebinding method and COMP, BSP, IL-lbeta, TNF-alpha and IL-6 by ELISA. The concentrations of PGS, COMP, BSP, IL-1 beta and TNF-alpha were high in the pre-PT program but that of IL-6 was in the normal level for all the participants [n=60]. Post PT measurement of laser and US groups showed a highly statistical reduction in PGS, COMP, BSP, IL-1 beta and TNF-alpha compared to the control group, IL-6 was significantly elevated in laser and US group compared to the control group. The finding of the present study suggested that PT modalities had a significant roll in controlling cartilage degradation process through inhibition of the catabolic factors and stimulating the inhibitors, suggesting that molecular markers can successfully assess PT rnodalities in various traumatic and rheumatic affections and also PT modalities can act as a prophylaxis against early OA