performing tuina on knee osteoarthritis (koa) rabbit model

Treating Knee Osteoarthritis with Tuina in a Rabbit Model

Knee osteoarthritis (KOA) is a degenerative disease of the knee joint, mainly manifested by knee pain, swelling, deformation, and restricted movement, with a high disability rate and a higher prevalence in women, with 527.81 million patients with osteoarthritis worldwide in 2019 and its global prevalence accounting for 60.6% of the total global prevalence of OA1. Clinically, the treatment of KOA is usually divided into non-surgical and surgical therapies. Non-surgical therapies include physiotherapy, pharmacotherapy, and platelet-rich plasma injection therapy2,3. Tuina is a common, safe, reliable, and effective treatment method in Chinese medicine. This study uses Tuina combined with the knee joint rotary correction method to treat KOA. Tuina techniques such as the rotatory kneading and pressing method can balance muscle tissue, reduce pain, adjust inflammatory factor levels, improve tissue metabolism, and inhibit articular cartilage degeneration4,5. The knee joint rotary correction method can adjust the alignment of lower limb bones and joints, improve the knee joint gap, restore the normal force line, and balance the lower limb biomechanics6,7,8,9. Resistance exercises can enhance muscle mass and strength and promote cartilage tissue renewal10,11. A preliminary study found that this Tuina protocol is significantly more effective than oral glucosamine sulfate capsules in treating KOA, with a faster onset of action and significant inhibition of chondrocyte degeneration and repair of damaged cartilage tissue12. In the treatment of KOA, compared to Tuina therapy, non-steroidal anti-inflammatory drugs have adverse effects and unsatisfactory long-term efficacy, relatively high surgical risks and costs, and require certain indications for surgical treatment, with postoperative problems and periprosthetic complications13,14,15. When compared to drug therapy and surgery, Tuina treatment for KOA offers several advantages, including reduced side effects, lower risk, enhanced safety, cost-effectiveness, and longer-lasting efficacy. Additionally, it can effectively alleviate knee joint pain, swelling, popping, and restricted movement6,13,16,17.
However, the mechanism of Tuina for the treatment of KOA needs to be clarified, which limits the improvement and perfection of the treatment protocol for KOA. Therefore, studying the mechanism of Tuina intervention in KOA through animal experiments is an effective method. Rabbits, compared to rats, have a docile temperament and larger knee joints. The anatomical structure and cartilage biochemical indexes are similar to those of humans, so it is a suitable subject for studying the mechanism of knee joint disease by Tuina18. The KOA model established by injecting papain into the knee joint cavity of rabbits has the advantages of short modeling time, reduced trauma, high success rate, high survival rate, and similar pathological mechanism to KOA19. This study aims to establish a scientifically feasible animal experimental protocol for Tuina intervention in KOA and investigate the mechanism of Tuina.

Author Spotlight: Using a Rabbit Model to Explore the Efficacy of Tuina in Treating Knee Osteoarthritis 

Tuina Intervention in Rabbit Model of Knee Osteoarthritis

When comparing the two types of therapy and the surgery, tuina treatment of full knee osteoarthritis offered several advantages, including reduced side effects, lower risk, enhanced safety, cost effectiveness, and longer-lasting efficacy. Additionally, it can effectively eliminate knee joint pain, swelling, popping, and restricted movement. This study offers scientifically sound, an affordable research particular, that will aid in exploring the mechanism underlying the effectiveness of tuina in the treatment of knee joint diseases.This study demonstrates the scientific feasibility of tuina treatment for knee osteoarthritis model rabit, highlighting its potential application in the study of knee osteoarthritis, and a similar knee joint-related conditions.

Watch this Scientific Journal Video about Performing Tuina on Knee Osteoarthritis KOA Rabbit Model at JoVE.com

Performing Tuina on Knee Osteoarthritis (KOA) Rabbit Model  

To begin Tuina intervention on the model rabbit with osteoarthritis established in its left knee, place the animal in the rabbit fixation box, and sooth it by gently stroking it for about 10 seconds. Perform the rotary kneading method using the thumb on the rabbit's left patella and the left peri-knee having muscle stiffness and tendon knots. Maintaining a force of 5 Newtons, perform an up and down, round tip manipulation at a frequency of 60 times per minute for five minutes.Then proceed to perform Tuina on the acupoints listed on the screen. Using the thumb end, press onto each acupoint, and maintaining the same force and frequency as demonstrated previously, operate on each point for 30 seconds. To perform rotary correction on the rabbit knee joint, hold the femur with one hand while positioning the other hand behind the knee joint.Fix the lateral and medial tibial condyles using the thumb and ring fingers respectively. Secure the popliteal fossa with the index and middle fingers. Using the fingers as demonstrated, hold the skin in place, avoiding friction between the skin and fingers.Then keeping the direction of traction force parallel to the long axis of the tibia, apply traction and twisting force. Secure the femur again with one hand. Establish a grip on the medial and lateral edges of the patella using the thumb and little fingers of the other hand while securing the base of the patella with the index, middle, and ring fingers.Then, keeping the direction of the torsion force in line with the direction of the lower Xiyan, apply a torsion force. Estimating the left knee ROM in the different groups of rabbits revealed that the Tuina group showed significant improvement in knee joint mobility after receiving the Tuina intervention from week seven. However, the model group that did not receive Tuina intervention showed no significant increase in ROM.

performing-tuina-on-knee-osteoarthritis-koa-rabbit-model

Research

JoVE Journal

Medicine

108 次观看.  Shandong University of Traditional Chinese Medicine. 要开始对左膝骨关节炎的模型兔进行推拿干预，请将动物放入兔子固定盒中，并通过轻轻抚摸约10秒钟来舒缓它。使用拇指在兔子的左髌骨和左膝周进行旋转揉捏方法，肌肉僵硬和肌腱结。保持 5 牛顿的力，以每分钟 60 次的频率进行上下圆头操作，持续 5 分钟。然后继续在屏幕上列出的穴位上进行推拿。使用拇指端按压每个穴位，并保持与前面演示的相同的力和频率，?...