ABSTRACT
OBJECTIVE: To assess serum sclerostin levels in relation to severity of arthropathy and bone mineral density (BMD) in children with hemophilic arthropathy. METHODS: This cross-sectional study included 40 male children suffering from Hemophilia A, and 10 matched healthy controls. Assessment of factor VIII deficiency degree, frequency of bleeding, type of treatment, body mass index (BMI), disease severity using the Hemophilia Joint Health Score (HJHS) and lumbar spine (LS) Z score for bone mineral density (BMD) using dual-energy X-ray absorbiometry was done. Serum sclerostin levels were measured for all patients and controls. RESULTS: Significant difference of serum sclerostin levels between the patient and control groups with Mean ± SD (0.09 ± 0.07 ng/ml) and (0.04 ± 0.01 ng/ml) (P value = 0.028) respectively was found. Significant positive correlations between serum sclerostin levels and the patients' age, and HJHS (P value <0.05) were found, while it had negative correlation with DEXA Z score, not reaching a significant value. LS-BMD-Z score levels ranged from (-4.5 to 1.2), with 15 patients with low BMD Z score (less than -2) representing 37.5% of total patients. CONCLUSIONS: Serum sclerostin levels are elevated in hemophilic children denoting bone metabolism affection and correlates with increased age, and HJHS. Increased levels of serum sclerostin may identify hemophilic patients at high risk for developing osteoporosis.
Subject(s)
Adaptor Proteins, Signal Transducing/blood , Bone Density , Hemarthrosis/blood , Hemophilia A/complications , Absorptiometry, Photon , Adolescent , Body Mass Index , Case-Control Studies , Child , Child, Preschool , Cross-Sectional Studies , Hemarthrosis/etiology , Hemarthrosis/pathology , Hemophilia A/blood , Hemophilia A/pathology , Humans , Male , Severity of Illness IndexABSTRACT
BACKGROUND: Osteoarthritis (OA) of the knee is the most common form of joint disease. It is one of the major causes of impaired function that reduces quality of life in older people worldwide. Periosteal Stimulation Therapy (PST) with boosters in combination with home exercises may be a suitable treatment option for such patients. OBJECTIVES: To examine the effectiveness of PST with boosters in addition to a home-based exercise program as compared with Transcutaneous Electrical Nerve Stimulation (TENS) combined with the same home-based exercise program in the management of chronic pain and functional impairments associated with advanced knee OA. DESIGN: The study was a randomized controlled trial. MATERIALS AND METHODS: Sixty patients with Kellgren-Lawrence grade 3 or 4 knee OA were randomized to receive PST or TENS once a week for 10 weeks, followed by boosters for 6 months in addition to a home exercise program. Visual Analogue Scale (VAS) and the Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales were assessed at baseline, after the last PST session, and 6 months later. RESULTS: Pain VAS and KOOS subscales were improved in both PST and TENS groups at 10 weeks and 6 months after intervention, with a statistically significant difference between the groups at both follow-up periods. Reduced pain VAS and increased KOOS subscales in the PST group were statistically significantly different from the TENS group during both follow-up periods. CONCLUSION: PST with boosters combined with a home exercise program was shown to be beneficial for improving subjective knee pain and functional performance of older patients with advanced knee OA.
