β-crosslaps in knee osteoarthritis – assessment and rehabilitation

Abstract

The bone turnover is important for the progression of osteoarthritis. The C-terminal telopeptide of type I collagen, β-CrossLaps (β-CTx) is considered as the first-choice bone resorption markers. Today, the biochemical markers have been associated with pain and disease severity in knee osteoarthritis (KOA) patients. We studied the association between β-CTx and functional status in KOA patients, pre- and postrehabilitation program. The primary goals of our study are both to establish the correlation between the serum level of β-CTx and other parameters of clinical and functional status in KOA patients and to compare the CTX-I values before and after rehabilitation program. We respected the actual international management recommendations for KOA. A total of 130 patients were randomly allocated into two distinct groups: Study Group (SG = 90 patients) performed 10 sessions of complete rehabilitation program (magnetodiaflux, transcutaneous nerve stimulation, ultrasound and low intensity laser treatment, kinetic measures), and Control Group (CG = 40 patients) performed 10 sessions of kinetic program. Both programs were performed daily, 5 days/week, 2 weeks. Evaluation of patients was carried out in two stages - initial (T1) and after 3 months (T2). Comparing the initial values with the final ones for β-CTx, we noticed a high significant difference between initial and final values only in SG patients. For the both T1 and T2 moments, there was no a statistically significant difference between β-CTx values from the two groups. Analyzing the differences between the values of clinical parameters (Six Minutes Walking Test, Timed Up-and-Go test, walk cadence and Symmetry index in walk) obtained between the patients from the two groups, we noticed that, for the T2 moment, there was a statistically significant difference between studied parameters, except walk cadence. In the assessment of global KOA patient status (clinical and functional status in accordance with bone-cartilage interface dynamics), β-CTx has significant value and could be used for monitoring the individualized rehabilitation program.