Regenerative Effects of Hyperbaric Oxygen Therapy on Orthopaedic Conditions

Ankle osteoarthritis is a condition that causes pain and stiffness in the ankle joint. Traditional treatments like joint fusion can limit mobility. An alternative procedure called ankle distraction arthroplasty has been gaining some traction, but how well does it hold up in the long term? 

A recent study by Greenfield et al. (2019) investigated this very question. They conducted a survival analysis of ankle distraction arthroplasty for ankle osteoarthritis. Their findings suggest that this procedure may be a viable option for some patients. 

Key takeaways from the study: 

  • Ankle distraction arthroplasty showed promising results, with an 84% survival rate at 5 years. This is better than some previously reported outcomes. 
  • The study also identified factors that can influence the success of the procedure. Avascular necrosis of the talus (bone death) was associated with a lower survival rate. Additionally, sex may play a role, with the study suggesting potential gender differences in long-term outcomes. 

What this means for patients: 

Ankle distraction arthroplasty offers a potential option for preserving joint mobility in patients with ankle osteoarthritis. This study provides valuable data for surgeons and patients to consider when making treatment decisions. 

Important to note: 

  • This was a retrospective study, meaning researchers analyzed past data. More robust research designs are needed to confirm these findings. 
  • The study involved a relatively small group of patients. Larger studies are necessary to draw more definitive conclusions. 

Overall, this research suggests that ankle distraction arthroplasty may be a valuable tool for treating ankle osteoarthritis. However, more research is needed to solidify its place as a standard treatment option. 

ReferenceGreenfield, S., Matta, K. M., McCoy, T. H., Rozbruch, S. R., & Fragomen, A. (2019). Ankle distraction arthroplasty for ankle osteoarthritis: a survival analysis. Strategies in trauma and limb reconstruction, 14(2), 65.,and%2037%25%20within%205%20years


This blog is for informational purposes only and should not be considered as medical advice. Always consult with a qualified healthcare professional to discuss your individual treatment options.

Regenerative Effects of Hyperbaric Oxygen Therapy on Orthopaedic Conditions
Image Credit: SpineUniverse 

“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.


[1] Regenerative effects of hyperbaric oxygen therapy and platelet-rich plasma on the osteochondral defects of rats:

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Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

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Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

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