Effect of Colchicine on Total Antioxidant Capacity,Antioxidant Enzymes and Oxidative Stress Markers in Patients with Knee Osteoarthritis

Background/Aim: We aimed to investigate the effects of colchicine on clinical recovery, as well as oxidative stress markers and total antioxidant capacity (TAC) in whole blood of patients with knee osteoarthritis (OA). Materials and methods: Sixty patients with grade 2 - 3 knee OA according to ACR knee OA criteria whom examination of the knee joint synovial fluid by polarized light microscopy demonstrated CPDD crystals existence were included in the study. Fifty healthy subjects were included as a control group. Patients were divided randomly into two groups. The first group (paracetamol group) was given only paracetamol 3 gr daily p.o and the second group (colchicine and paracetamol group) was given colchicine 1,5 gr and paracetamol 3 gr daily p.o for six months. For outcome measures WOMAC and VAS were used. Superoxide dismutase (SOD), Catalase (CAT) ezyme activities and Glutathione (GSH) and Malondialdehyde (MDA) levels and TAC all were measured. Results: WOMAC scores were improved in both patient groups compared with pre-treatment evaluation (p 0.05). TAC was signifcantly increased only in colchicine/paracetamol group. Oxidant parameter MDA levels were significantly decreased in both paracetamol group and colchicine/paracetamol group. CAT, SOD enzyme activities and GSH levels did not change before and after treatment protocols in both patient groups. Conclusion: Both paracetamol 3000 mg/day and 3000 mg paracetamol plus 1,5 gr/day colchicine is effective in the treatment of patients with knee osteoarthritis. But the addition of colchicine to paracetamol produced significantly greater symptomatic benefit than paracetamol alone. Our study also showed that colchicine lowers whole blood MDA which is a lipid peroxidation compound and elevates TAC levels in patients with knee OA. This may show probable disease modifying effect of colchicine in knee OA which require further long period laboratory and radiologic investigations.

Comparison of Rehabilitation Outcomes with Acoustic Radiation Force (ARFI) Elastosonography in Hemiplegic Patients Treated with Neuromuscular Electrical Stimulation

To evaluate the gastrocnemius/soleus and biceps brachii muscle stiffness by Acoustic Radiation Force Impulse (ARFI) elastography in the hemiplegia patients, sixty patients with hemiplegia after stroke were recruited. Baseline data were collected including age, gender, body mass index, education level, dominant side, affected side, time since stroke, stroke etiology. All patients were evaluated with before treatment and posttreatment with Broonstroom staging, Modified Ashworth spasticity scale, and Functional Independence Measures scale. The patient was divided into 3 groups: 1) Neuromuscular electrical stimulation group, 2) Rehabilitation group, 3) Neurumusculer electrical stimulation + Rehabilitation group. Affected and unaffected side biceps and gastrocnemius, ARFI elastography measurements were used to measure thickness and elastic values. In addition, before and after treatment, length and thickness were measured from all patients. Of the 60 subjects, 28 were female (46.7%) and 32 (53.3%) were males, with an average age of 58.42 ± 9.03 years. There was a significant difference between the upper and lower limbs after the treatment in terms of Brunstroom staging. In terms of Modified Ashworth scale, there was a significant difference in lower extremity only after treatment. When compared to the affected/unaffected side, before and after treatment, there was a significant difference in the measurements in both the medial gastrocnemius and the lateral gastrocnemius in all three groups. Further research with larger numbers of patients for longer periods is needed to clarify the relationship between the muscle hardness and degree of spasticity.