Tuina Intervention in Sodium Monoiodoacetate Injection-Induced Rat Model of Knee Osteoarthritis

We're trying to broaden the views on the research of knee osteoarthritis by introducing the perspective of refocusing on muscle inflammation during the pathological process of the KOA. There is a recent trend in non-pharmacological therapy treating the knee osteoarthritis. Therapy measures of traditional Chinese medicine such as Tui na and acupuncture are receiving more and more recognition.

There is a calling for detailed mechanism in the treatment. Our experiments indicates the possibility of chronic muscle inflammation in the process of knee osteoarthritis. It also points out the possibility of non pharmacological therapy such as Tui na to treat and control it.

To begin, randomly assigned rats into four groups, each containing eight animals after one week of adaptive feeding. After shaving and disinfecting the right hind limb of the anesthetized rat, carefully fix the knee flexion at a precise angle of 90 degrees with the patella ligament oriented upward. Subsequently inject 25 microliters of monoaota acetate solution into the right knee joint cavity of the rats.

Using experimental acupuncture, accurately locate the acupuncture points shown here on the rat to target for finger kneading. Then use rat fixation equipment to secure the rat in the prone position. Once the rat is calm and its lower, limbs are relaxed.

Need EXLE four and ST35 of the affected limb with the thumb and index finger simultaneously for four minutes. Then need the anterior and medial lateral muscles of the affected limb with the thumb and index finger for three minutes. Focus on SP10, ST34, and the muscles near the knee joint.

Using the thumb, index finger, and middle finger, knead the posterior calf muscles of the affected limb from top to bottom. To expose the treatment area fully, hold the ankle joint of the affected limb with the ring finger and little finger while gently tugging on the limb. Focus on SP9, GB34 and the muscles near the knee joint.

To begin, take sodium monoaota acetate injection induced rat model of knee osteoarthritis and performed Tui na on the affected limb with the thumb and index finger. Bring the rats to a quiet planter test room with a stainless steel grid bottom, and a plastic cage for 30 minutes of adaptation at room temperature. Then use an electronic mechanical pain tester with a plastic test needle of 0.8 millimeters in diameter to stimulate the central area of the right hind foot of the rat's vertically.

Record the reading displayed on the electronic screen as the mechanical pain threshold of the right planter foot of the rat. Afterward, remove the maximum and minimum values from the five values. Take the average value of the middle three values through the trimmed mean method.

In a heated planter quiet test room, place the rats in a plastic cage with a glass bottom maintained at 30 degrees Celsius for 30 minutes to adapt them. Then with a light source heating device at a stimulation temperature of 65 degrees Celsius, stimulate the right hind planter center area until the rat shows a paw retraction and avoidance response. Now, record the time reading displayed on the electronic screen as the right planter thermal pain threshold of the rat.

Remove the maximum and minimum values from the five values. Take the average value of the middle three values through the trimmed mean method as the result to measure the swelling of the right knee joint. Place the rat in a flat position on the operating table.

Measure the width of the right knee joint using vernier calipers. Use a plastic test needle to stimulate the lateral side of the right knee joint, assess the response and assign a score on a scale ranging from zero to three. Next, position the rat on the operating table.

Evaluate the gait of its right hind limbs and assign a score on a scale of zero to three according to the observed response. Then manually flex and extend the right knee joint of the rat, assess the joint mobility and score the response on a scale of zero to three. Touch the right knee joint of the rat.

Compare the response to that of a normal rat and assign a score on a scale of zero to two. A comparison of mechanical and thermal pain showed that Tui na intervention without the blockade of the PD one pathway had relieved the pain significantly. Implementation of Tui na decreases knee swelling significantly.

The Lequest MG Index also suggested that manual therapy could serve as an adjunctive approach for enhancing knee osteoarthritis symptom management in rats.