Humans ; Osteoarthritis, Knee ; diagnosis ; therapy

PURPOSE: The purpose of this study is to know the effect of high intensive laser therapy in patients with early stage of osteoarthritis of knee. MATERIALS AND METHODS: This study was a randomized, double blind controlled trial. 28 patients who had grade II osteoarthritis of Kellgren classification and knee pain were randomly divided into two groups. Patients underwent treatment 30 times, 5 times per week. the clinical evaluation was done by the pain, stiffness and functional score of the knee by the knee society clinical rating system, and the intensity of pain was measured also by a VAS (visual analogue scale), before and after the 1st sessions, Before and after the 2nd sessions and at 6 month after the 1st treatment. We checked hs-CRP and HA which was regarded as indexes of osteoarthritis activitiy. RESULTS: As a clinical result of high intensive laser therapy, VAS, pain and functional score were statistically more improved than those of before therapy, except stiffness (P<0.05). The results of the hs-CRP and HA which were not significantly different from those of before therapy. In the placebo group, all variables showed no difference. CONCLUSION: We concluded that Nd-YAG high intensive laser therapy in early stage of patient with osteoarthritis of knee would be helpful as noninvasive and conservative treatment for improvement clinical progress.
Humans ; Knee ; Laser Therapy ; Lasers, Solid-State ; Osteoarthritis ; Osteoarthritis, Knee

This study aims to assess the efficacy and safety of Hulisan Capsules in the treatment of knee osteoarthritis, which is expected to serve as a reference for clinical practice. To be specific, randomized controlled trial(RCT) on the treatment of knee osteoarthritis with Hulisan Capsules was retrieved from EMbase, PubMed, Cochrane Library, Web of Science, CNKI, Wanfang, SinoMed, and VIP(from inception to November 15, 2021). Two researchers independently screened the articles, extracted the data, and evaluated the risk of bias with ROB. RevMan 5.4 was used for Meta-analysis. Finally, 12 RCTs were screened out, involving 1 703 cases(1 075 in the experimental group and 628 in the control group). Meta-analysis showed that conventional treatment + Hulisan Capsules was superior to conventional treatment alone in terms of symptom relief rate(RR=1.19, 95%CI[1.09, 1.30], P<0.000 1), Lysholm score(MD=11.17, 95%CI[7.35, 15.00], P<0.000 01), visual analogue scale(VAS) score(MD=-0.99, 95%CI[-1.30,-0.68], P<0.000 01), and knee function score(RR=8.94, 95%CI[6.51, 11.37], P<0.000 01). Hulisan Capsules alone was superior to the conventional treatment alone in terms of the symptom relief rate(RR=1.38, 95%CI[1.13, 1.69], P=0.002) and knee function score(MD=2.88, 95%CI[0.81, 4.94], P=0.006), but VAS score was insignificantly different between the patients treated with Hulisan Capsules alone and those with conventional treatment alone(MD=-0.57, 95%CI[-1.42, 0.29], P=0.19). Hulisan Capsules + conventional treatment showed insignificant difference in symptom relief rate from the Zhuifeng Tougu Capsules + conventional treatment(RR=1.07, 95%CI[0.91, 1.25], P=0.44). The Lequesne score was insignificantly different between Hulisan Capsules + conventional treatment and conventional treatment/Zhuifeng Tougu Capsules + conventional treatment(MD=-2.17, 95%CI[-6.29, 1.96], P=0.30). The incidence of adverse reactions in the experimental group was significantly lower than control group(RR=0.57, 95%CI[0.34, 0.96], P=0.03). According to the available data and methods, Hulisan Capsules/Hulisan Capsules + conventional treatment could improve the symptom relief rate, Lysholm score, knee function score, and VAS score of patients with knee osteoarthritis, and alleviate the symptoms of pain, stiffness, and swelling of them. No serious adverse reactions were found yet. In the future, more large-sample and standard clinical trials are needed to verify the effect and safety of Hulisan Capsules in the treatment of knee osteoarthritis.
Humans ; Osteoarthritis, Knee/drug therapy* ; Capsules ; Pain

A review of the non-pharmacologic madalities was done by Puett 1994. Of the 7 cited modalities, exercise was found to be the most beneficial. Acupuncture and health education were not found to be effective. Ettinger, et al, in 1997 studied 439 patients aged 60 and above. He found that aerobic and resistance exercise were found most beneficial among patients with advancing age.
THERAPY ; PAIN ; ARTHRITIS ; PRACTICE GUIDELINE ; OSTEOARTHRITIS

OBJECTIVETo compare clinically therapeutic effects of warming needle moxibustion and simple acupuncture on knee osteoarthritis.

METHODSOne hundred and twenty cases conformed with the diagnostic criteria of knee osteoarthritis with TCM kidney-yang deficiency and cold syndrome were randomly divided into a warming needle moxibustion group and a simple acupuncture group. Guanyuan (CV 4), Qihai (CV 6), Zusanli (ST 36) and others were selected in the two groups. Their therapeutic effects were assessed with joint pain scale, knee osteoarthritis severity index scale and cold syndrome differentiation factors.

RESULTSBoth warming needle moxibustion and simple acupuncture could alleviate pain of knee osteoarthritis, improve dysfunction of the knee joint, reduce symptoms. The clinically basic cured rate and the total effective rate were 32.1% and 96.4% in the warming needle moxibustion group, which were better than 7.4% and 92.6% in the simple acupuncture group.

CONCLUSIONWarming needle moxibustion is an effective therapy for knee osteoarthritis with kidney-yang deficiency and cold type.

Professor Li Zhi-dao has special method to treat knee osteoarthritis. He pays great attention to Feijing Zouqi method; beside the traditional acupoints, he creates two groups of acupoints: nine acupoints of the anterior or the posterior of the thigh, and what's more, he emphasises on improving the function of tendon; he particularly adopts fire needle therapy for the severe and invalidism patients. In addition, professor Li Zhi-dao pays great attention to the effect of the model and method of exercise on the osteoarthritis, and he advocates the patient should keep right active and passive movement of knee joint.
Acupuncture Points ; Acupuncture Therapy ; methods ; Humans ; Osteoarthritis, Knee ; therapy

Strengthening the compliance is conductive to the quality improvement of clinical trial of acupuncture and moxibustion. In terms to planning behavior and influencing factors of loyalty, the questionnaire was conducted among 200 participants on the compliance of clinical trial on knee osteoarthritis treated with acupuncture. The results showed that the subjective norms and perceptual behavior control of subjects affected their compliance in the trial. Medical service compensation became the primary factor of the subjects' loyalty, which further affected their compliance in the trial. It is suggested that the compliance should be managed according to the characteristics of different clinical researches, and the feasible medical service compensation scheme should be designed in advance by actively focusing on the subjects' features.
Acupuncture Therapy ; Humans ; Moxibustion ; Osteoarthritis, Knee/therapy* ; Surveys and Questionnaires

BACKGROUND: When research based evidence is not sufficient, clinical practice guidelines can be based on opinions. In such situations, formal consensus development methods, often based on the modified nominal group techniques are widely used. It can be used to evaluate consistency, generalizability, applicability of recommendation when evidence comes from other countries. METHODS: To develop evidence based guidelines for osterarthritis pharmacotherapy, a consensus expert panel consisting of internists, family physicians, methodologists, and orthopedic surgeons were convened. After an extensive structured literature searching and evaluation, evidence statements for key question were developed. Rating methods for consistency, generalizability, applicability of statement were adopted from those jointly developed by Rand and the University of California, Los Angeles. RESULTS: We developed 27 evidence statements in 17 question domains. Among 72 rating items, 62 items reached agreement. Among 15 recommendations, 10 recommendation grading were A, 2 were B, and 3 were C. CONCLUSION: When research based evidence is not sufficient, clinical practice guidelines can be based on formal consensus of experts, especially modified nominal group techniques. It can be used to evaluate consistency, generalizability, applicability of recommendation when evidence comes from other countries.
California ; Consensus ; Drug Therapy ; Humans ; Orthopedics ; Osteoarthritis ; Physicians, Family

The treatment ideas with acupuncture for knee osteoarthritis (KOA) are explored on the base of Dongyuan needling technology. Regarding the rules of acupoint selection, Zusanli (ST 36) is predominant, the back-shu points are used for the disorders related to the invasion of exogenous factors, and the front-mu points are for the cases caused by internal injury. Besides, the xing-spring points and shu-stream points are preferred. In treatment of KOA, besides the local points, the front-mu points, i.e. Zhongwan (CV 12), Tianshu (ST 25) and Guanyuan (CV 4), are selected specially to tonifying the spleen and stomach. The earth points and acupoints on the earth meridians (i.e. Yinlingquan [SP 9], Xuehai [SP 10], Liangqiu [ST 34], Dubi [ST 35], Zusanli [ST 36] and Yanglingquan [GB 34]) are optional to coordinate yin and yang, essence and qi , and regulate the qi movement of spleen and stomach. The shu-stream points of liver, spleen and kidney meridians (Taichong [LR 3], Taibai [SP 3] and Taixi [KI 3]) are chosen to promote meridian circulation and regulate zangfu functions.
Humans ; Osteoarthritis, Knee ; Acupuncture Therapy ; Meridians ; Acupuncture Points ; Spleen

OBJECTIVE: To observe the distribution characteristics and rules of pain sensitivity points on body surface in patients with knee osteoarthritis (KOA). METHODS: A total of 916 patients with KOA were selected in this study, the pain sensitivity points of local site of knee joint were probed by thumb palpation. Tape was used to measure the distance between the pain sensitivity points and the most nearby acupoints. The Wagner tenderness measuring instrument was used to measure the tenderness threshold of pain sensitivity points. RESULTS: A total of 3618 pain sensitivity points were probed, among them, 3338 pain sensitivity points were sensitized. The minimum sensitization degree was 1.00, the maximum sensitization degree was 3.39, while the average sensitization degree was (2.16±0.60). Pain sensitivity points were distributed 0.37-1.73 CONCLUSION The pain sensitivity points of patients with KOA may be the expansion effect of acupoint areas in the disease states, pain sensitivity points are more likely to appear on the medial side of knee joint.
Acupuncture Points ; Humans ; Knee Joint ; Osteoarthritis, Knee/therapy* ; Pain Threshold