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Abstract

Introduction

Protocol

Representative Results

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Medicine

Clinical Effects of Ultrasound-Guided Acupotomy in Knee Osteoarthritis Treatment

Published: April 26th, 2024

DOI:

10.3791/66587

1Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine, 2Shanghai Pudong New Area Guangming Hospital of Traditional Chinese Medicine

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, 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 < 0.05), the Hospital for Special Surgery Knee Score (HSS) was significantly higher than before treatment (p < 0.05), the Visual analogue scale (VAS) was significantly lower than those of the control group (p < 0.05) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were significantly lower than those of the control group (p < 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.

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....

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All patients with KOA were evaluated in the outpatient Department of TCM Rehabilitation at Guangming Hospital of Shanghai Pudong New Area from June 2022 to June 2023 for a total of 60 cases. This study was approved by the ethics review committee at Guangming Hospital of Traditional Chinese Medicine of Shanghai Pudong New Area (Ethics number: GMEC-KY-2020034). Doctors informed patients and their families regarding the clinical significance, risks, and follow-up requirements of the study. Patients were included in the stud.......

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During the study, one patient received additional other treatments (intra-articular steroid injection) due to increased pain. In one patient, the synovial thickness of the suprapatellar bursae could not be detected on ultrasonography. One patient developed swelling and subcutaneous stasis around the wound after treatment, which improved after ice application without affecting normal treatment and follow-up. Two patients terminated the experiment, and the remaining 58 patients were included in the final statistical analys.......

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There are three aspects of the treatment procedure that need special attention. The first is tenderness point localization. The surface of the total knee joint should be pressed to mark the location of the patient's pain response through the patient's complaint and the doctor's palpation. Peroneal collateral ligament and iliotibial band point, patellar lateral retinaculum point, quadriceps tendon and suprapatellar bursa point, patellar medial retinaculum point, tibial collateral ligament point, pes anserinus .......

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We are grateful to Shanghai Three-year Action Plan to Further Accelerate the Inheritance and Innovation of Traditional Chinese Medicine (ZY(2021-2023)-0201-01); Pudong New Area Health System Pudong Famous TCM Training Program (PWRzm2020-15); Chinese Medicine Rehabilitation Service Enhancement Project (Medical 032); Innovation project of Longhua Hospital: Clinical study of acupotomy combined with knee balance exercise in the treatment of knee osteoarthritis (CX202045); Clinical study of acupotomy combined with Mulligan dynamic joint loosening in the treatment of periarthritis of shoulder (PKJ2020-Y76); Pudong New Area Health Commission Pudong Famous Chinese Medicine Su....

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NameCompanyCatalog NumberComments
Disposable sterile injection needleShanghai Mishava Medical Industry Co., Ltd601900973Type specification:0.5 x 38 RWLB
Disposable medical maskShanghai Honglong Medical Supplies Equipment Co., LTD20162140493Type specification: 17.5 x 9.5cm
Disposable sterile small needle-knifeWujiang Yunlong Medical equipment Co., LtdPR-4040Type specification:40 mm x 40 mm 
Disposable sterile syringeShandong Weigo Group Medical polymer Products Co., Ltd601909174Type specification:10 mL
Disposable sterile towelXinxiang Huakang Medical Material Co., LT20182140517Type specification: 80x100cm
Hygiene hatShanghai Honglong Medical Supplies Equipment Co., LTD20150071Type specification: 21x14cm
Lidocaine hydrochlorideShanghai Hefeng Pharmaceutical Co., Ltd6904996104121Type specification:5 mL
Marker penZebra Trading (Shenzhen) Co., Ltd4901681518111Type specification:1.0 mm/0.5 mm
Sterile absorbent cotton ballShanghai Honglong Medical Supplies Equipment Co., Ltd601905637Type specification:0.3  25 g
Sterile disposable medical plastic cupShanghai Honglong Medical Supplies Equipment Co., Ltd709008633Type specification:Waist-shaped disc
Sterile dressing blockNingbo Haishu Shenyuan Medical Materials Co.,  Ltd601909470Type specification:7.5 cm x 7.5 cm x 8 floors
Sterile medical tweezersShanghai Honglong Medical Supplies Equipment Co.,Ltd603917444Type specification:Small size
Sterile protective cover for probeYangzhou Puen Medical Technology Co., LTD20200046Type specifications: 20x150cm
Sterile rubber surgical glovesGuilin Hengbao health protection Co.,  Ltd6971787071320Type specification:6.5
Sterile self-adhesive dressingShanghai ISO Medical Products Co., Ltd601909414Type specification:10 cm x 15 cm
Sterile ultrasonic couplerJiangsu Huadong Medical Equipment Industrial Co., LTD6972830280430Type Specifications: 20g
Sterile water for injectionShanghai Xinyi Jinzhu Pharmaceutical Co., Ltd6938493300953Type specification:5 mL
Type II skin disinfectantShanghai Likang Disinfection high-tech Co., Ltd6909157000359Type specification:500 mL/ bottle
UltrasoundSuzhou Daer Medical Equipment Co., Ltd100018857uSmart3300 portable color ultrasound system

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