The Journal of Practical Medicine >

2026 , Vol. 42 >Issue 5: 768 - 776

DOI: https://doi.org/10.3969/j.issn.1006-5725.2026.05.006

Chronic Disease Control

Study on clinical therapeutic effect mechanism of Shi's trauma manipulation on knee osteoarthritis based on human biomechanics

  • Fuwei PAN ,
  • Min ZHANG ,
  • Zhengyan LI ,
  • Jiehang LU ,
  • Yuqi CHEN ,
  • Pei LI ,
  • Hongsheng ZHAN
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  • 1.School of Traumatology and Orthopedics of Traditional Chinese Medicine，Henan University of Chinese Medicine，Zhengzhou 450046，Henan，China
    2.Orthopedic Diagnosis and Treatment Center，the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine，Zhengzhou 450002，Henan，China
    3.Shi′s Center of Orthopedics and Traumatology，Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine，Shanghai 201203，Shanghai，China
    4.College of Traditional Chinese Medicine，Zhengzhou Health College，Zhengzhou 450064，Henan，China

Received date: 2025-12-14

  Online published: 2026-03-09

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Abstract

Objective To observe the alterations in the clinical condition and biomechanical parameters of medial compartment knee osteoarthritis （KOA） treated with manipulation， and to explore the mechanism underlying the clinical biomechanical effect of manipulation on KOA. Methods Sixty-two eligible subjects with KOA in the medial compartment were recruited from the Orthopedic Center of the Second Affiliated Hospital of Henan University of Traditional Chinese Medicine and Shi's Trauma Center of Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine. The control group received basic therapy for 8 weeks， whereas the experimental group was treated with Shi's "eight methods of regulating muscles and bones and treating knees"， with each session lasting 20 minutes， twice a week for 8 weeks. The Western Ontario and McMaster University Osteoarthritis Index （WOMAC） scores were employed to assess the subjects' conditions before and after the intervention. The VICON 3D gait analysis system and NORAXON wireless surface electromyograph were utilized to collect gait parameters in terms of time-space， kinematics， dynamics， and motor aspects. Results Compared with the control group， there were statistically significant differences in pain， stiffness， function， and total score between the observation group and the control group （P < 0.05）. In terms of time-space parameters， the observation groups showed significant differences in step size （P < 0.05）. The peak angles of internal rotation and external rotation of the control group before and after the intervention were statistically significant （P < 0.05）， and the same was true for the observation group before and after the intervention （P < 0.05）. There were no statistically significant differences in the kinetic parameters between the two groups before and after the intervention （P > 0.05）. There were significant changes in the parameters of VMM/MG and VM/ST in the early and middle supporting phases after the intervention in the observation group （P < 0.05）. Conclusion Based on the application of Hot Compress No.1， Shi's traumatology manipulation can significantly improve the condition of patients with medial compartment KOA. Meanwhile， the spatio-temporal， kinematic， dynamic， and motor parameters related to the knee joints of the lower limbs are improved to a certain extent. This suggests that the previously deteriorated biomechanical environment has been improved， revealing part of the biomechanical mechanism of manipulation in treating KOA.

Key words： knee osteoarthritis; Shi's traumatology; manipulation; gait analysis; surface electromyography; biomechanics

Cite this article

Fuwei PAN , Min ZHANG , Zhengyan LI , Jiehang LU , Yuqi CHEN , Pei LI , Hongsheng ZHAN . Study on clinical therapeutic effect mechanism of Shi's trauma manipulation on knee osteoarthritis based on human biomechanics[J]. The Journal of Practical Medicine, 2026 , 42(5) : 768 -776 . DOI: 10.3969/j.issn.1006-5725.2026.05.006

References

[1] WOOD G， NEILSON J， COTTRELL E， et al. Osteoarthritis in people over 16： Diagnosis and management-updated summary of NICE guidance［J］. Brit Med J， 2023， 380： 24. doi：10.1136 /bmj.p24 .
[2] 2021 OSTEOARTHRITIS COLLABORATORS GBD. Global， regional， and national burden of osteoarthritis， 1990-2020 and projections to 2050： A systematic analysis for the Global Burden of Disease Study 2021［J］. Lancet Rheumatol， 2023， 5（9）： e508-e522. doi： 10.1016/S2665-9913 （23）00163-7 .
[3] WENG Q， JIANG T， YANG T， et al. Association of thigh intramuscular fat infiltration with incident knee and hip osteoarthritis： A longitudinal cohort study［J］. Arthritis Rheumatol， 2025， 77（9）： 1205-1215. doi： 10.1002/art.43159 .
[4] 陆洁航， 张旻， 李正言， 等. 基于“筋出槽、骨错缝”论治膝骨关节炎［J］. 中医杂志， 2024， 65（7）： 755-759. doi：10.13288/j.11-2166/r.2024.07.016 .
[5] 潘富伟， 陈元川， 张旻， 等. 从筋论治膝骨关节炎的新思考［J］. 中华中医药杂志， 2022， 37（6）： 3040-3044.
[6] 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.doi：3760/cma.j.cn121113-20210624-00424 .
[7] ALTMAN R D. Classification of disease： osteoarthritis［J］. Semin Arthritis Rheum， 1991， 20（6 ）： 40-47. doi： 10.1016/0049-0172（91）90026-v .
[8] ZHANG M， LIU A， PAN F， et al. The effectiveness of massage on pain， external knee adduction moment， and muscle Co-contraction in individuals with medial compartment knee osteoarthritis［J］. J Bodyw Mov Ther， 2024， 40： 1672-1678. doi： 10.1016/j.jbmt.2024.09.006 .
[9] 许学猛， 刘文刚， 许树柴， 等. 膝骨关节炎（膝痹）中西医结合临床实践指南 ［J］. 实用医学杂志， 2021， 37（22）： 2827-2833. doi： 10.3969/j.issn.1006-5725.2021.22.001 .
[10] 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 .
[11] ANGST F， AESCHLIMANN A， STUCKI G. Smallest detectable and minimal clinically important differences of rehabilitation intervention with their implications for required sample sizes using WOMAC and SF-36 quality of life measurement instruments in patients with osteoarthritis of the lower extremities［J］. Arthritis Rheum， 2001， 45（4）： 384-391. doi： 10.1002/1529-0131（200108） 45：4<384：：AID-ART352>3.0.CO；2-0 .
[12] 张兴雷， 田松云. 独活寄生汤联合热敷一号治疗膝关节骨性关节炎临床观察［J］. 中医学报， 2018， 33（6）： 1111-1114. doi：10.16368/j.issn.1674-8999.2018.06.264 .
[13] HERMENS H J， FRERIKS B， DISSELHORST-KLUG C， et al. Development of recommendations for SEMG sensors and sensor placement procedures［J］. J Electromyogr Kinesiol， 2000， 10（5）： 361-374. doi： 10.1016/s1050-6411（00）00027-4 .
[14] RUDOLPH K S， AXE M J， BUCHANAN T S， et al. Dynamic stability in the anterior cruciate ligament deficient knee［J］. Knee Surg Sports Traumatol Arthrosc， 2001， 9（2）： 62-71. doi： 10.1007/s001670000166 .
[15] PAN J， XIE Z， SHEN H， et al. Three-dimensional gait biomechanics in patients with mild knee osteoarthritis［J］. Sci Rep， 2025， 15（1）： 32061. doi： 10.1038/s41598-025-17398-z .
[16] MESSIER S P， DEVITA P， COWAN R E， et al. Do older adults with knee osteoarthritis place greater loads on the knee during gait？ A preliminary study［J］. Arch Phys Med Rehabil， 2005， 86（4）： 703-709. doi： 10.1016/j.apmr.2004.05.015 .
[17] 段敬瑞， 薛艳， 顾新丰， 等. 石氏伤科手法配合自制膏药治疗膝骨关节炎60例［J］. 世界最新医学信息文摘， 2019， 19（8）： 243-245. doi：10.19613/j.cnki.1671-3141.2019.08.126 .
[18] 李锡， 张健， 刘郭辉， 等. 脊柱-骨盆-下肢力线正骨手法治疗膝骨关节炎的疗效评价［J］. 实用医学杂志， 2024， 40（17）： 2495-2502. doi： 10.3969/j.issn.1006-5725.2024.17.024 .
[19] 何增林. 牵拉调膝法治疗膝骨关节炎的临床研究［D］. 济南：山东中医药大学， 2024.
[20] ZHU S， QU W， HE C. Evaluation and management of knee osteoarthritis［J］. J Evid Based Med， 2024， 17（3）： 675-687. doi： 10.1111/jebm.12627 .
[21] JIANG Z， HE A， Zheng N， et al. Medial Compartment Knee Osteoarthritis Altered Tibiofemoral Joint Kinematics and Contact Pattern During Daily Weight-Bearing Extension［J］. Orthop Surg， 2025， 17（5）： 1478-1485. doi： 10.1111/os.70023 .
[22] IKUTA F， YONETA K， MIYAJI T， et al. Knee kinematics of severe medial knee osteoarthritis showed tibial posterior translation and external rotation： A cross-sectional study［J］. Aging Clin Exp Res， 2020， 32（9）： 1767-1775. doi： 10.1007/s40520-019-01361-w .
[23] STARKEY S C， DIAMOND L E， HINMAN R S， et al. Muscle Forces during Weight-Bearing Exercises in Medial Knee Osteoarthritis and Varus Malalignment： A Cross-Sectional Study［J］. Med Sci Sports Exerc， 2022， 54（9）： 1448-1458. doi： 10.1249/MSS.0000000000002943 .
[24] DU X， LIU Z Y， TAO X X， et al. Research progress on the pathogenesis of knee osteoarthritis［J］. Orthop Surg， 2023， 15（9）： 2213-2224. doi： 10.1111/os.13809 .
[25] MUNDERMANN A， DYRBY C O， HURWITZ D E， et al. Potential strategies to reduce medial compartment loading in patients with knee osteoarthritis of varying severity： Reduced walking speed［J］. Arthritis Rheum， 2004， 50（4）： 1172-1178. doi： 10.1002/art.20132 .
[26] SKVORTSOV D， KAURKIN S， PRIZOV A， et al. Biomechanical changes in gait patterns of patients with grade ii medial gonarthritis［J］. Diagnostics （Basel）， 2021， 11（7）： 1242. doi： 10.3390/diagnostics11071242 .
[27] SARA L K， FELSON D T， TILLEY S， et al. The relation of walking forces to structural damage in the knee： The Multicenter Osteoarthritis Study［J］. Osteoarthritis Cartilage， 2025， 33（6）： 745-752. doi： 10.1016/j.joca.2025.04.007 .
[28] WU Y， LI A， SUN N， et al. Unveiling the mechanisms of mechanical loading-induced knee osteoarthritis through transcriptomics［J］. Int Immunopharmacol， 2025， 157： 114785. doi： 10.1016/ j.intimp.2025.114785 .
[29] LIU S， DU Z， SONG L， et al. Factors， characteristics and influences of the changes of muscle activation patterns for patients with knee osteoarthritis： A review［J］. J Orthop Surg Res， 2025， 20（1）： 112. doi： 10.1186/s13018-025-05484-x .
[30] ZENI J A， RUDOLPH K， HIGGINSON J S. Alterations in quadriceps and hamstrings coordination in persons with medial compartment knee osteoarthritis［J］. J Electromyogr Kinesiol， 2010， 20（1）： 148-154. doi： 10.1016/j.jelekin.2008.12.003 .
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