Screening for dysbaric osteonecrosis in hyperbaric chamber inside attendants: a clinical and radiological evaluation

Abstract

Aim: This study aimed to evaluate the clinical and radiological development of dysbaric osteonecrosis (DON) in hyperbaric chamber inside attendants who are exposed to prolonged and repetitive hyperbaric conditions during hyperbaric oxygen therapy (HBOT) sessions.
Materials and Methods: This retrospective study included 17 inside attendants who regularly participated in HBOT sessions between 2016 and 2022 at the Gülhane and Akyurt Hyperbaric Medicine Clinics. Demographic and clinical characteristics and the number of HBOT sessions were recorded. Plain radiographs of the hips, knees, and shoulders were reviewed for signs of DON.
Results: The mean age of participants was 41.3 ± 6.95 years, and the median body mass index was 26.1 kg/m². None of the 17 participants had a history of decompression sickness, steroid use, or regular alcohol consumption; hyperlipidemia was detected in only 4 individuals. The mean number of HBOT exposures was 272 ± 148 sessions. No joint pain or radiological signs of DON were observed in any participant.

Conclusions: The absence of clinical and radiological evidence of DON despite high cumulative exposure suggests that HBOT, when conducted under medically controlled protocols, appears safe for this occupational group. Further prospective studies with larger sample sizes and advanced imaging techniques are needed to validate these findings.