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Isr Med Assoc J. 2017 Jul;19(7):429-434.

The Role of Hyperbaric Oxygen Therapy in Orthopedics and Rheumatological Diseases.

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Department of Internal Medicine, IRCCS San Raffaele Pisana, Rome, Italy.
Orthopedic Unit, Santissima Trinità Unit Hospital, Cagliari, Italy.
Maxillofacial Unit, Santissima Trinità Unit Hospital, Cagliari, Italy.
Hyperbaric Unit, Marino Hospital, Cagliari, Italy.
Rheumatology Unit, Sacco University Hospital, Milan, Italy.
IRCCS Galeazzi Orthopedic Institute, Milan, Italy.


Hyperbaric oxygen therapy (HBOT) has been investigated as a primary/adjunctive treatment for a number of injuries and medical conditions including traumatic ischemia, necrotizing soft tissue injuries, non-healing ulcers and osteoradionecrosis, but the results are controversial. There is insufficient evidence to support or reject the use of HBOT to quicken healing or to treat the established non-union of fractures. However, in patients with fibromyalgia, HBOT reduces brain activity in the posterior cortex and increases it in the frontal, cingulate, medial temporal and cerebellar cortices, thus leading to beneficial changes in brain areas that are known to function abnormally. Moreover, the amelioration of pain induced by HBOT significantly decreases the consumption of analgesic medications. In addition, HBOT has anti-inflammatory and oxygenatory effects in patients with primary or secondary vasculitis. This review analyzes the efficacy and limitations of HBOT in orthopedic and rheumatologic patients.

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