SynthesisBMC musculoskeletal disorders2026
Effects of hyperbaric oxygen therapy on human musculoskeletal pathologies in clinical studies: a systematic review.
Synthesis in BMC musculoskeletal disorders, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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Who cites it
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundHyperbaric oxygen therapy (HBOT) has gained increasing interest in regenerative medicine for its capacity to enhance tissue oxygenation, reduce inflammation, and accelerate healing. While its use in musculoskeletal medicine is expanding, particularly among athletes and in sports orthopaedics, the clinical evidence base remains fragmented across indications and has not been systematically evaluated. PURPOSE: The aim of this systematic review was to synthesize the available clinical evidence for HBOT in human musculoskeletal pathologies, with focus on its application in orthopaedic medicine.
methodsA systematic PubMed and LIVIVO search identified clinical studies (January 1996 - January 2026) investigating intervention-based studies using HBOT for musculoskeletal conditions in humans. Exclusion criteria were combinatory therapies, transplantations, radiation injuries, osteomyelitis, spine and oral surgery. Data on study design, HBOT protocols and their outcomes was collected. A qualitative synthesis was performed due to heterogeneity in study designs and outcome measures. Risk of bias was assessed using Cochrane RoB 2 tool (RCTs) and ROBINS-I V2 (non-RCTs). Studies were categorized by pathology (muscle/tendons/ligament injury; avascular necrosis (AVN) and bone marrow edema (BME)).
resultsNineteen studies involving 612 patients met our inclusion criteria. Conditions included exercise-induced muscle damage (EIMD) and its symptomatic manifestation delayed onset muscle soreness (DOMS), ligament injuries, AVN, BME, and tendon perfusion. Evidence for HBOT's effects in DOMS/EIMD was limited, with RCTs showing no significant benefit. Conversely, AVN and BME studies reported consistent improvements in imaging, pain and functional scores, particularly with prolonged protocols. Limited evidence suggested potential benefits in ligament healing; tendon oxygenation effects were inconclusive. HBOT protocols ranged from 1 - 12 sessions for soft-tissue and 20 - 80 sessions for bone injuries, mainly using 60 to 90 minute sessions with 100% oxygen. Adverse events were rare and mild. Most RCTs showed low risk of bias; non-randomized studies had serious-to-critical bias due to confounding and measurement issues.
conclusionsHBOT may have a role as an adjunctive therapy for musculoskeletal pathologies, especially AVN and BME, where the most consistent evidence was observed, while its benefit in ligament injuries, muscle recovery, and tendon pathology remains inconclusive and requires higher-quality trials to substantiate. CLINICAL RELEVANCE: This topic is directly relevant to orthopaedic and sports medicine practitioners considering its off-label use. This review identifies conditions with the most consistent clinical benefit, highlights the limitations of current evidence, and defines priorities for future high-quality trials to guide safe and effective clinical implementation. STUDY
designSystematic review.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.