“Good health and good sense are two of life’s greatest blessings.” Publilius Syrus
Article Authors: Gordon Slater| Tandose Sambo
Hyperbaric Oxygen Therapy is a medical treatment that involves a patient breathing in pure oxygen in a controlled environment. Initially utilised as a decompression treatment for scuba divers, other medical conditions such as wounds induced by diabetes, are now being treated with hyperbaric oxygen therapy. Patients are treated in a chamber that contains pressurised air up to three times the atmospheric pressure. The higher pressure increases the available oxygen to the lungs. Extra oxygen benefits the lungs, and cleanses and heals the body.
Medical studies have fused hyperbaric oxygen (HBO) therapy, with an infusion of platelet rich plasma and investigated the regeneration of osteochondral defects in rats. The synergy of these two treatments will subsequently be scaled up to human treatment and treat future orthopaedic conditions. The experimental details are outlined in the reference below, and the results will be discussed in this article.
Thirty two female Wistar albino rats underwent iatrogenic injury, and were classified according to control, PRP, HBO and HBO+PRP groups. The rats then underwent arthrotomy and osteochondral surgery on the sites. The regeneration of their injuries was subsequently assessed to identify the optimum conditions for healing.
According to the study, there was a slight improvement in the healing of rats who were classified as HBO or PRP when compared to the control group. The significant difference was found in the fourth group, which had the combined effects of both HBO and PRP. A synergistic relationship is being exhibited by the combination of the two.
Medical science is currently attempting to identify the underlying mechanisms that are at play in this fusion. A potential theory is that there are growth factors that are activated and accumulated during the treatment. With the catalysed growth of healing enhancers such as growth factors it will be possible to achieve higher rates of regeneration than with the individual treatments.
Applications in Orthopaedic Care
A frequently encountered orthopaedic medical condition involves the damage of joint cartilage in patients. The root causes may vary, and include weight loading on the joints that ultimately destroys the joint. The treatment of osteochondral lesions in damaged joints is currently a condition that is difficult to treat. Achieving full-thickness of the cartilage after joint damage often does not occur. The healing mechanism, if it does occur, generates a fibrous cartilage, instead of the original cartilage that existed in the joint cavity.
In an attempt to recreate the natural healing mechanisms of the body, various options have been tried. Methods such as autogenic or allogeneic grafts with a hyaline cartridge haven’t proven to be effective. More modern methods such as the utilisation of mesenchymal stem cells have achieved desired results at a very high cost. The utilisation of alternate therapies such as HBO and PRP infusions aims to moderate the cost of treatment, yet still achieve the desired results. The fact that osteoarthritis is so prevalent in patients generates a solid business case for optimising orthobiologic treatments for osteoarthritis or any condition that requires the regeneration of cartilage.
The aforementioned study aims to accelerate tissue regeneration via the infusion of analogous blood products in humans, particularly platelet-rich plasma (PRP). HBO has proven its effectiveness on tissue regeneration, particularly in diabetic foot wounds.
Reference:
[1] Regenerative effects of hyperbaric oxygen therapy and platelet-rich plasma on the osteochondral defects of rats: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7489163/