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.
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Method Article
Clinical Effects of Ultrasound-Guided Acupotomy in Knee Osteoarthritis Treatment
In This Article
Summary
Abstract
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.
Introduction
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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Protocol
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 study after obtaining and signing informed consent either from the patients or their families. The surgeon was familiar with the anatomy of the knee joint....
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Results
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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Discussion
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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Disclosures
The authors report no conflict of interest.
Acknowledgements
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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Materials
| Name | Company | Catalog Number | Comments |
|---|---|---|---|
| Disposable sterile injection needle | Shanghai Mishava Medical Industry Co., Ltd | 601900973 | Type specification:0.5 x 38 RWLB |
| Disposable medical mask | Shanghai Honglong Medical Supplies Equipment Co., LTD | 20162140493 | Type specification: 17.5 x 9.5cm |
| Disposable sterile small needle-knife | Wujiang Yunlong Medical equipment Co., Ltd | PR-4040 | Type specification:40 mm x 40 mm |
| Disposable sterile syringe | Shandong Weigo Group Medical polymer Products Co., Ltd | 601909174 | Type specification:10 mL |
| Disposable sterile towel | Xinxiang Huakang Medical Material Co., LT | 20182140517 | Type specification: 80x100cm |
| Hygiene hat | Shanghai Honglong Medical Supplies Equipment Co., LTD | 20150071 | Type specification: 21x14cm |
| Lidocaine hydrochloride | Shanghai Hefeng Pharmaceutical Co., Ltd | 6904996104121 | Type specification:5 mL |
| Marker pen | Zebra Trading (Shenzhen) Co., Ltd | 4901681518111 | Type specification:1.0 mm/0.5 mm |
| Sterile absorbent cotton ball | Shanghai Honglong Medical Supplies Equipment Co., Ltd | 601905637 | Type specification:0.3 25 g |
| Sterile disposable medical plastic cup | Shanghai Honglong Medical Supplies Equipment Co., Ltd | 709008633 | Type specification:Waist-shaped disc |
| Sterile dressing block | Ningbo Haishu Shenyuan Medical Materials Co., Ltd | 601909470 | Type specification:7.5 cm x 7.5 cm x 8 floors |
| Sterile medical tweezers | Shanghai Honglong Medical Supplies Equipment Co.,Ltd | 603917444 | Type specification:Small size |
| Sterile protective cover for probe | Yangzhou Puen Medical Technology Co., LTD | 20200046 | Type specifications: 20x150cm |
| Sterile rubber surgical gloves | Guilin Hengbao health protection Co., Ltd | 6971787071320 | Type specification:6.5 |
| Sterile self-adhesive dressing | Shanghai ISO Medical Products Co., Ltd | 601909414 | Type specification:10 cm x 15 cm |
| Sterile ultrasonic coupler | Jiangsu Huadong Medical Equipment Industrial Co., LTD | 6972830280430 | Type Specifications: 20g |
| Sterile water for injection | Shanghai Xinyi Jinzhu Pharmaceutical Co., Ltd | 6938493300953 | Type specification:5 mL |
| Type II skin disinfectant | Shanghai Likang Disinfection high-tech Co., Ltd | 6909157000359 | Type specification:500 mL/ bottle |
| Ultrasound | Suzhou Daer Medical Equipment Co., Ltd | 100018857 | uSmart3300 portable color ultrasound system |
References
- Joo, P. Y., Borjali, A., Chen, A. F., Muratoglu, O. K., Varadarajan, K. M. Defining and predicting radiographic knee osteoarthritis progression: A systematic review of findings from the osteoarthritis initiative. Knee Surg Sports Traumatol Arthrosc. 30 (12), 4015-4028 (2022).
- Tan, X. F., Guo, Y. X.
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