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Evaluation of the curative effect of traditional Chinese medicine bone-setting technique in the treatment of knee osteoarthritis
Received date: 2024-05-24
Online published: 2024-09-13
Objective To observe the clinical effect of traditional Chinese medicine bone-setting technique using spinal， pelvi-lower extremity line to treat patients with knee osteoarthritis （KOA）. Methods 426 patients with KOA were all from the First Affiliated Hospital of Hebei University of Traditional Chinese Medicine. They were randomly divided into experimental group （384 cases， 57 cases of elimination， shedding and termination） by computer generated sequence. Traditional Chinese bone setting techniques were applied with spinal-pelvic-lower limb force line （divided into three parts： lumbar fixed point reduction method， hip joint push-pull and extension method and knee peripheral tendon recovery method every 3 days. 2 weeks） treatment； The control group was the waiting treatment group （48 cases， 6 cases were eliminated， abscission， termination）， which was only used for clinical observation for 2 weeks. The main outcome index was WOMAC pain score. Secondary outcome measures were WOMAC stiffness score， functional score， standardized score and quality of life score （SF-12）. The test time points were baseline， 2 weeks after enrollment， and follow-up （14 weeks after enrollment）. The control group was at baseline and 2 weeks after enrollment. Results Compared with baseline， WOMAC pain score， stiffness score， functional score and standardized score were all decreased in 2 groups 2 weeks after enrollment （P < 0.05）， but the experimental group was significantly decreased compared with the control group （P < 0.001）. SF-12 quality of life scores were all higher than before （P < 0.001）， but the experimental group was significantly higher than the control group （P < 0.001）. At follow-up， compared with 2 weeks after enrollment， WOMAC pain scores were increased （P < 0.001）， WOMAC stiffness， joint function and standardized scores were decreased （P < 0.001）， and SF-12 scores were increased （P < 0.001）. Conclusion The use of spinal - pelvi-lower extremity line of traditional Chinese medicine bone-setting technique in the treatment of KOA is effective in improving the knee joint function and improving the quality of life of patients， but the short-term effect of pain relief is good， and the long-term effect is not good. Its safety is good， and it can be considered in clinical application for KOA patients with joint dysfunction as the main manifestation.
Xi LI , Jian ZHANG , Guohui LIU , Yunhao LIU , Zekun ZHANG , Tianci GAO , Jingxi WANG , Yongwang ZHANG , Shilin YIN , Lu LIU , Liqing QI , Shuangqing. DU . Evaluation of the curative effect of traditional Chinese medicine bone-setting technique in the treatment of knee osteoarthritis[J]. The Journal of Practical Medicine, 2024 , 40(17) : 2495 -2502 . DOI: 10.3969/j.issn.1006-5725.2024.17.024
| 1 | LI E， TAN J， XU K，et al. Global burden and socioeconomic impact of knee osteoarthritis：a comprehensive analysis［J］. Front Med，2024，11：1323091. doi:10.3389/fmed.2024.1323091 |
| 2 | FENG Y， WU Y， LIU H，et al. Effect of the telemedicine-supported multicomponent exercise therapy in patients with knee osteoarthritis： study protocol for a randomized controlled trial［J］. Trials，2023，24（1）：729. doi:10.1186/s13063-023-07749-4 |
| 3 | LONG H， LIU Q， YIN H， WANG K，et al. Prevalence Trends of Site-Specific Osteoarthritis From 1990 to 2019： Findings From the Global Burden of Disease Study 2019［J］. Arthritis Rheumatol，2022，74（7）：1172-1183. doi:10.1002/art.42089 |
| 4 | 中华医学会骨科学分会关节外科学组，中国医师协会骨科医师分会骨关节炎学组，国家老年疾病临床医学研究中心（湘雅医院），等. 中国骨关节炎诊疗指南（2021年版）［J］. 中华骨科杂志，2021，41（18）：1291-1314. |
| 5 | ZENG C， DOHERTY M， PERSSON M S M，et al. Comparative efficacy and safety of acetaminophen，topical and oral non-steroidal anti-inflammatory drugs for knee osteoarthritis： evidence from a network meta-analysis of randomized controlled trials and real-world data［J］. Osteoarthritis Cartilage，2021，29（9）：1242-1251. doi:10.1016/j.joca.2021.06.004 |
| 6 | OSSENDORFF R， THIMM D， WIRTZ D C，et al. Methods of Conservative Intra-Articular Treatment for Osteoarthritis of the Hip and Knee［J］. Dtsch Arztebl Int，2023，120（35/36）：575-581. |
| 7 | DANTAS L O， SALVINI T F， MCALINDON T E. Knee osteoarthritis： key treatments and implications for physical therapy［J］. Braz J Phys Ther，2021，25（2）：135-146. doi:10.1016/j.bjpt.2020.08.004 |
| 8 | JOHANSSON M S， POTTEGARD A， SONDERGAARD J，et al. Use of prescribed analgesics before and after exercise therapy and patient education in patients with knee or hip osteoarthritis［J］. Rheumatol Int，2024，44（2）：319-328. doi:10.1007/s00296-023-05432-0 |
| 9 | 胡珊珊，刘晓，罗汉才，等. 低强度脉冲超声调控治疗疼痛性膝骨关节炎的临床研究［J］. 实用医学杂志，2023，39（21）：2783-2788. |
| 10 | 张政，谢利民，丁全茂，等. 膝骨关节炎中医推拿治疗技术规范专家共识［J］. 中医杂志，2020，61（16）：1469-1472. |
| 11 | 白杨. 专家共识手法治疗膝骨关节炎临床疗效和安全性初步评价［D］. 北京：北京中医药大学，2021. |
| 12 | 郭珍妮. 近十年推拿治疗退行性膝骨关节炎的文献挖掘及分析［D］. 成都：成都中医药大学，2020. |
| 13 | 中华医学会骨科学分会关节外科学组，中国医师协会骨科医师分会骨关节炎学组，国家老年疾病临床医学研究中心（湘雅医院），等. 骨关节炎诊疗指南（2018年版）［J］. 中华骨科杂志，2018，38（12）：705-715. |
| 14 | KELLGREN J H， LAWRENCE J S. Radiological assessment of osteoarthrosis［J］. Ann Rheum Dis，1957，16（4）：494-502. doi:10.1136/ard.16.4.494 |
| 15 | BELLAMY N， BUCHANAN W W， GOLDSMITH C H，et al. Validation study of WOMAC： a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee［J］. J Rheumatol，1988，15（12）：1833-1840. |
| 16 | BELLAMY N. Pain assessment in osteoarthritis： experience with the WOMAC osteoarthritis index［J］. Semin Arthritis Rheum，1989，18（4 ）：14-17. doi:10.1016/0049-0172(89)90010-3 |
| 17 | CLEGG D O， REDA D J， HARRIS C L，et al. Glucosamine，chondroitin sulfate，and the two in combination for painful knee osteoarthritis［J］. N Engl J Med，2006，354（8）：795-808. doi:10.1056/nejmoa052771 |
| 18 | WARE J J R， KOSINSKI M， KELLER S D. A 12-Item Short-Form Health Survey： construction of scales and preliminary tests of reliability and validity［J］. Med Care，1996，34：220-233. doi:10.1097/00005650-199603000-00003 |
| 19 | 元唯安，张明才，詹红生. 对“骨错缝、筋出槽”的认识及临床诊断［J］. 中国骨伤，2013，26（6）：502-504. doi:10.3969/j.issn.1003-0034.2013.06.014 |
| 20 | 张健，王响，焦永伟，等. 正骨松筋疗法结合筋氏葆熏洗对老年重度骨性关节炎患者膝关节功能及关节力线的影响［J］. 辽宁中医杂志，2019，46（7）：1441-1444. |
| 21 | 张永旺，薛炳鹤，范宇 等. 腰-膝共治法治疗早中期膝关节骨性关节炎临床研究［J］. 河北中医药学报， 2021，36（6）：20-23+33. |
| 22 | 李锡，颜运涛，刘路，等. 运用髋关节推摇拔伸手法治疗初、早期膝骨关节炎：随机对照研究［J］. 北京中医药大学学报，2023，46（12）：1756-1762. |
| 23 | BOVA G， DOMENICHIELLO A， LETZEN J E，et al. Developing consensus on core outcome sets of domains for acute，the transition from acute to chronic，recurrent/episodic，and chronic pain：results of the INTEGRATE-pain Delphi process［J］. E Clin Med，2023，66：102340. doi:10.1016/j.eclinm.2023.102340 |
| 24 | DIAMOND L E， GRANT T， UHLRICH S D. Osteoarthritis year in review 2023： Biomechanics［J］. Osteoarthritis Cartilage， 2024，32（2）：138-147. doi:10.1016/j.joca.2023.11.015 |
| 25 | FU P， XU W， XU P，et al. Relationship between spinal imbalance and knee osteoarthritis by using full-body EOS［J］. BMC Musculoskelet Disord，2023，24（1）：402. doi:10.1186/s12891-023-06508-5 |
| 26 | IWASAKI K， OHKOSHI Y， HOSOKAWA Y，et al. Higher Association of Pelvis-Knee-Ankle Angle Compared With Hip-Knee-Ankle Angle With Knee Adduction Moment and Patient-Reported Outcomes After High Tibial Osteotomy［J］. Am J Sports Med，2023，51（4）：977-984. doi:10.1177/03635465221150513 |
| 27 | KECHAGIAS V A， GRIVAS T B. Hip-Spine and Knee-Spine Syndrome： Is Low Back Pain Improved After Total Hip and Knee Arthroplasty？［J］. Cureus，2024，16（4）：e57765. |
| 28 | MCGARGILL S， SEIN M， SIBILLE K T，et al. Considerations beyond spine pain： do different co-occurring lower body joint pains differentially influence physical function and quality of life ratings？［J］. BMC Musculoskelet Disord，2024，25（1）：269. doi:10.1186/s12891-024-07393-2 |
| 29 | STRAHOVNIK A， STRAHOVNIK I， FOKTER S K. Coronal Knee Alignment and Tibial Rotation in Total Knee Arthroplasty： A Prospective Cohort Study of Patients with End-Stage Osteoarthritis［J］. Bioengineering （Basel），2024，11（3）：296. doi:10.3390/bioengineering11030296 |
| 30 | CARVALHO C， SERRAO F V， PISANI G K，et al. Frontal plane biomechanics during single-leg squat and hip strength in patients with isolated patellofemoral osteoarthritis compared to matched controls：A cross-sectional study［J］. PLoS One，2022，17（4）：e0267446. doi:10.1371/journal.pone.0267446 |
| 31 | HERNANDEZ-HERMOSO J A， NESCOLARDE L， YANEZ-SILLER F，et al. Combined femoral and tibial component total knee arthroplasty device rotation measurement is reliable and predicts clinical outcome［J］. J Orthop Traumatol，2023，24（1）：40. doi:10.1186/s10195-023-00718-2 |
| 32 | BOEKESTEIJN R J， VAN GERVEN J， GEURTS A C H，et al. Objective gait assessment in individuals with knee osteoarthritis using inertial sensors：A systematic review and meta-analysis［J］. Gait Posture，2022，98：109-120. doi:10.1016/j.gaitpost.2022.09.002 |
| 33 | 刘雨龙，宁仁德，方闰，等. X线下胫骨平台与股骨远端解剖学测量关系在Schatzker Ⅳ-C胫骨平台骨折术后临床疗效的评估价值［J］. 实用医学杂志，2024，40（9）：1257-1261. |
| 34 | MOSENG T， VLIET VLIELAND T P M， BATTISTA S，et al. EULAR recommendations for the non-pharmacological core management of hip and knee osteoarthritis：2023 update［J］. Ann Rheum Dis，2024，83（6）：730-740. doi:10.1136/ard-2023-225041 |
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