Effect of acupotomy in knee osteoarthritis patients: study protocol for a randomized controlled trial

Abstract

Background Symptomatic knee osteoarthritis (KOA) is common in China. Pharmacological therapy is not the first recommendation because of its safety issues. Nonpharmacological therapy, such as lifestyle adjustments, weight loss, muscle strengthening, and aerobic exercise programs, is strongly recommended for KOA. However, these approaches may fail due to poor patient compliance. There is a lack of high-quality randomized controlled trials of acupotomy, an effective treatment for KOA. This study was designed to investigate the efficacy of acupotomy in patients with KOA. Methods A total of 136 patients will be enrolled at the First Affiliated Hospital of Guangzhou University of Chinese Medicine and assigned to the acupotomy group or sham acupotomy group according to the block randomization scheme. Patients in the acupotomy group will receive 2 sessions of acupotomy for 2 weeks (once a week). Patients in the sham group will receive 2 sessions of sham stimulation for 2 weeks (once a week). All patients will use indomethacin cream externally. The primary outcome will be the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and the secondary outcomes will be the visual analog scale (VAS) score, plantar pressure distribution test result, X-ray examination findings, musculoskeletal ultrasound findings, maximum knee circumference, joint mobility, and quality of life. Measurements will be taken at baseline, 1 week after the end of treatment, and at the 3- and 6-month follow-ups. Discussion To the best of our knowledge, this will be the first single-blind, sham-controlled study of acupotomy. The outcome assessors will also be blinded. The aim of this work is to demonstrate the efficacy of acupotomy in treating KOA. Trial registration Chinese Clinical Trial Registry ChiCTR2000033047. Registered on 18 May 2020.

Clinical efficacy of acupuncture therapy combined with core muscle exercises in treating patients with chronic nonspecific low back pain: a systematic review and meta-analysis of randomized controlled trials

“…In the sensitivity analyses of the included studies, we excluded two studies with greater heterogeneity (27,29), which involved using bladed needles and needle knives with a loosening effect. Needle knives and bladed needles originated from the ancient "nine-needle" therapy, which differs from the round needle with a pointed tip of traditional acupuncture, with a thicker diameter and a flattened and bladed tip, except for the effect of regulating qi and blood of the traditional acupuncture, which can peel off and loosen the adhesion, contracture of the tendons, and relieve the nerve and blood vessel from the pressing stimulation (38)(39)(40)(41). The study revealed that the needle knife with loosening effect and blade needle have a better effect on improving the functional status of patients' waist; however, we included fewer studies with smaller sample sizes, and the research data to argue the possibility of the cause of this heterogeneity are insufficient.…”

Mind-body exercises for mild to moderate Knee osteoarthritis: non-inferiority study protocol for a parallel, single-center randomized controlled trial

“…KOA is a prevalent ailment that canlead to substantial debilitation, yet the underlying etiology of KOA remains enigmatic. Research has revealed that the degeneration of articular cartilage and alterations in synovial composition are pivotal pathological changes associated with this condition (19). Clinical guidelines offer divergent recommendations (10)(11)(12) encompassing both pharmacological and nonpharmacological interventions to address the symptoms of KOA.…”

Proteomic Analyses Reveals the Mechanism of Acupotomy Intervention on the Treatment of Knee Osteoarthritis in Rabbits

“…Accumulating evidences proved that acupotomy therapy was an effective treatment for KOA [ 14 – 16 ]. For example, Wang et al (2019) reported that the application of acupotomy clearly alleviated the symptoms of KOA in rabbits by changing the arrangement of fibrous tissue [ 8 ].…”