ultrasound-guided acupotomy procedure to treat knee osteoarthritis

Managing Knee Osteoarthritis Using Ultrasound-Guided Acupotomy

Knee osteoarthritis (KOA) is the most common degenerative disease of the knee joint, causing knee pain, bony enlargements, morning stiffness, knee activity limitations, and other symptoms. Knee pain and limited function are the primary factors affecting daily life and work in patients with KOA. Most people with KOA experience a partial or complete loss of the ability to work and self-care, which is the primary cause of chronic disability1. Epidemiological data2,3 show that the prevalence of KOA is positively correlated with age. With the aging Chinese population, the incidence of KOA is increasing every year. Globally, approximately 250 x 106 patients have osteoarthritis, and its incidence is increasing annually. By 2030, osteoarthritis will be one of the main causes of disability4, with approximately 85% of osteoarthritis cases of the knee5,6, which seriously affects the quality of life of patients and causes pain in their life and work, leading to a heavy economic burden to the country and individuals7,8. Therefore, finding safe and minimally invasive treatments for patients with KOA is an area of intense research in orthopedics.
The main treatments for KOA include conservative therapies like patient education, lifestyle adjustments, physical therapy, orthopedic aids and orthotics, and medication and surgery. The vast majority of intra-knee surgery is performed through arthroscopic surgery with little trauma and a low infection rate. However, arthroscopic surgery still has some traumatic effects. Patients with KOA often undergo surgery after conservative treatment has failed9.
Acupotomy is a less invasive surgery than arthroscopy. Acupotomy can be performed in conjunction with conservative treatment. The needle knife is generally about 10-15 cm long and 0.4-1.2 mm in diameter. The needle knife consists of three parts: handle, needle body, and blade. The blade is thin and sharp. Its width is equal to the diameter of the needle body. Traditional acupotomy refers to the treatment of tendon pain points by a surgeon under the condition that the internal tissue structure of the human body cannot be directly observed; the interventional treatment is carried out according to his/her own experience and knowledge of the local anatomical tissue, combined with the symptoms and tender points of the patient. Due to the high risk of the procedure, including damage to the surrounding soft tissues, nerves, and blood vessels, infection, uncertain effects, and the possibility of multiple procedures, the use of traditional acupotomy is quite limited. With the development of imaging technology, the use of visualization has become a developing trend in acupotomology10 and has broadened the clinical application of acupotomy. Ultrasound can be used to visualize muscle and fascial lesions in real-time, allowing complete identification of the relative anatomy and the lesions11,12, improving the accuracy and safety of acupotomy13. Currently, it is primarily used to treat joint pain in the neck, shoulder, waist, and leg14,15. Ultrasound-guided acupotomy has the advantages of being a precisely targeted therapy, low risk, few complications, and high safety. Therefore, this study evaluated ultrasound-guided acupotomy as a new therapeutic approach for KOA.

Author Spotlight: Minimally Invasive Ultrasound-Guided Acupotomy in Knee Osteoarthritis Treatment

Clinical Effects of Ultrasound-Guided Acupotomy in Knee Osteoarthritis Treatment

The incidence of knee osteoarthritis is increasing with the aging population. Therefore, we're interested in exploring safe and minimally invasive treatments for patients with KOA. The main treatments for KOA include conservative therapies, like patient education, lifestyle adjustments, physical therapy, orthopedic aids and orthotics, and medication, and intra-knee surgery.Patients with KOA often undergo surgery after the failure of conservative treatment. Acupotomy can be performed in conjunction with conservative treatment. Acupotomy is a less invasive surgery than arthroscopy.Ultrasound-guided acupotomy can be used to visualize muscle and fissure lesions in real time, allowing complete identification of relative anatomy and the lesions, thereby improving the accuracy and safety of acupotomy.

Ultrasound-Guided Acupotomy Procedure to Treat Knee Osteoarthritis

ultrasound-guided-acupotomy-procedure-to-treat-knee-osteoarthritis

Research

JoVE Journal

Medicine

The protocol presented here demonstrates the operation method of ultrasound-guided acupotomy for knee osteoarthritis (KOA), including patient recruitment, preoperative preparation, manual operation, and postoperative care. The purpose of this protocol is to relieve pain and improve knee function in patients with KOA. A total of 60 patients with KOA admitted between June 2022 and June 2023 were treated with ultrasound-guided acupotomy. Pathological changes and knee function scores were compared before and after the treatment. After 1 week of treatment, the synovial thickness of the suprapatellar bursae was significantly lesser than before treatment (p &lt; 0.05), the Hospital for Special Surgery Knee Score (HSS) was significantly higher than before treatment (p &lt; 0.05), the Visual analogue scale (VAS) was significantly lower than those of the control group (p &lt; 0.05) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were significantly lower than those of the control group (p &lt; 0.05). Therefore, ultrasound-guided acupotomy for the treatment of KOA can reduce synovial thickness, relieve pain, improve knee joint function, and have a remarkable curative effect.

This paper introduces the operation method of ultrasound-guided acupotomy for knee osteoarthritis, which can reduce synovial thickness and improve knee joint function. It has the advantages of precise target, low treatment risk, few complications, and high safety.

The protocol presented here demonstrates the operation method of ultrasound-guided acupotomy for knee osteoarthritis (KOA), including patient recruitment, ...