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In This Article

  • Summary
  • Abstract
  • Introduction
  • Protocol
  • Representative Results
  • Discussion
  • Acknowledgements
  • Materials
  • References
  • Reprints and Permissions

Summary

The protocol describes a method for Tuina intervention in a rabbit model of knee osteoarthritis.

Abstract

Knee osteoarthritis (KOA) is mainly characterized by degenerative changes in the knee joint's cartilage and surrounding soft tissues. The efficacy of Tuina in treating KOA has been confirmed, but the underlying mechanism needs to be investigated. This study aims to establish a scientifically feasible KOA rabbit model treated with Tuina to reveal the underlying mechanisms. For this, 18, 6-month-old normal-grade male New Zealand rabbits were randomly divided into sham, model, and Tuina groups, with 6 rabbits in each group. The KOA model was established by injecting 4% papain solution into the knee joint cavity. The Tuina group was intervened with Tuina combined with the knee joint rotary correction method for 4 weeks. Only the standard grasping and fixation were performed in sham and model groups. At the end of the 1-week intervention, the knee joint range of motion (ROM) was observed, and cartilage hematoxylin-eosin (HE) staining was done. The study shows that Tuina could inhibit chondrocyte apoptosis, repair cartilage tissue, and restore knee joint ROM. In conclusion, this study demonstrates the scientific feasibility of Tuina treatment for KOA model rabbits, highlighting its potential application in the study of KOA and similar knee joint-related conditions.

Introduction

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....

Protocol

The study was approved by the ethics committee of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine (approval number: 2020-29).

1. Experimental animals

  1. Raise 18, 6-month-old normal-grade male New Zealand rabbits (2.75 ± 0.25 kg) in standard single cages (12 h light/dark cycle, temperature 20-24 °C, air humidity 40%-60%).

2. Grouping method

  1. Select 6 out of the 18 N.......

Representative Results

The degree of restricted knee motion and cartilage tissue damage reflects the severity of KOA. The knee joint's ROM reflects the degree of restriction of knee joint motion. The smaller the knee joint ROM, the more serious the limitation of knee joint motion. On the contrary, the bigger the knee joint ROM, the more normal the degree of knee motion. HE staining to observe the morphology and structure of cartilage tissue reflects the degree of cartilage tissue damage. The more irregular the surface of cartilage tissue, .......

Discussion

The design of the experimental protocol is particularly important to investigate the mechanism of Tuina in treating KOA. KOA modeling was performed on rabbits by injection of papain at Waixiyan. Waixiyan is located in the lateral crypt of the patellar ligament, which is easy to locate, and the joint space between the femur and tibia is large here during knee flexion, which makes it easy to inject into the knee joint cavity and prevents damage to the surrounding tissues, so it is easy to establish the KOA model

Acknowledgements

This work was supported by the Shandong Provincial Traditional Chinese Medicine Science and Technology Project (2021Q080) and the Qilu School of Traditional Chinese Medicine Academic School Inheritance Project [Lu-Wei-Letter (2022) 93].

....

Materials

NameCompanyCatalog NumberComments
0.9 % sodium chloride injectionSichuan Keren Pharmaceutical Co.Z22121903
-20°C refrigeratorHaierBD-328WL
4 % fixative solutionSolarbioP1110
4°C refrigeratorHaierSC-315DS
Anhydrous ethanolSinopharm
Automatic tissue dewatering machineDakowei (Shenzhen) Medical Equipment Co.HP30
Blast drying ovenShanghai Yiheng Scientific Instruments Co.DHG-9070A
CoverslipBiyuntianFCGF50
Electric thermostat water bathShanghai Yiheng Scientific Instruments Co.HWS-26
Embedding freezing tableChangzhou Paishijie Medical Equipment Co.BM450
Embedding machineChangzhou Paishijie Medical Equipment Co.BM450A
Ethylenediaminetetraacetic acid decalcification solutionServicebioG1105-500ML
Fluorescent inverted microscopeLeicaLeica DM IL LED
Hematoxylin-eosin staining kitCisco JetEE0012
Hydrochloric acidLaiyang Economic and Technological Development Zone Fine Chemical Plant
Medical joint goniometerKOSLO
Neutral gumCisco JetEE0013
Normal-grade male New Zealand rabbitJinan Xilingjiao Breeding and Breeding CenterSCXK (Lu) 2020 0004
Papain(3000 U/mg)BiossD10366
Pathological tissue bleaching and drying instrumentChangzhou Paishijie Medical Equipment Co.PH60
Pet electric clippersCodosCP-3180
Rabbit fixing boxany brand
Rotating SlicerLeica531CM-Y43
Tuina technique parameter determination instrumentShanghai DuKang Instrument Equipment Co. Ltd.ZTC-figure-materials-2994
VentilatorTALY ELECTRICC32
XyleneFuyu Reagent

References

  1. Long, H. B., et al. Prevalence trends of site-specific osteoarthritis from 1990 to 2019: findings from the global burden of disease study 2019. Arthritis & Rheumatology. 74 (7), 1172-1183 (2022).
  2. Tschopp, M., et al.

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TuinaKnee OsteoarthritisRabbit ModelCartilageJoint Range Of MotionChondrocyte ApoptosisKnee Joint Disease

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