Effect of hyperbaric oxygen therapy (HBO) on osteoblasts of elderly patients on calcification and osteoprotegerin.

BACKGROUND: Osteoporosis stands as one of the most prevalent bone diseases worldwide. This study aims to explore the effects of Hyperbaric Oxygen (HBO) therapy and substances that reduce reactive oxygen species (ROS), such as antioxidants, on osteogenic differentiation and key osteoporosis-related parameters in osteoblasts derived from elderly patients requiring hip arthroplasty. METHODS: An in vitro study was conducted using osteoblasts isolated from the femoral heads of 22 patients (78.3 % female) with a mean age of 73 years. Bone mineral density (BMD) was assessed through dual-energy X-ray absorptiometry (DXA), classifying patients into three groups: normal (age-appropriate) BMD (n = 8), osteopenia (n = 6), and osteoporosis (n = 8). Osteogenic differentiation was induced, and HBO therapy was administered over a period of 21 days. Additionally, osteoblasts were treated with catalase. Parameters related to osteogenic differentiation and osteoporosis were evaluated. RESULTS: HBO therapy prompted osteogenic differentiation in all three experimental groups after 21 days, with statistically significant findings (p = 0.0125) in osteoblasts with age-appropriate bone density. Furthermore, the activity of alkaline phosphatase (ALP), an enzyme indicative of bone synthesis, demonstrated significant increases across all groups following HBO treatment (normal BMD and osteoporotic cells: p = 0.04; osteopenic cells: p = 0.006). CONCLUSIONS: These findings suggest that HBO therapy holds potential as an adjunctive or investigational treatment for elderly patients to enhance bone density or facilitate bone healing post-fracture, especially in those with normal or osteopenic bone density. This approach could potentially influence clinical practices in the future.