Journal of Pharmacopuncture (대한약침학회지)

KOREAN PHARMACOPUNCTURE INSTITUTE (대한약침학회)
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Biopuncture, A Multitarget Therapy in the Treatment of Individuals with Knee Osteoarthritis: state of the art

  • Pedro Ivan Arias-Vazquez (Rehabilitation Medicine, Sports Medicine, Department of Rehabilitation, Multidisciplinary Academic Division of Comalcalco, Autonomous Juarez University of Tabasco) ;
  • Maria Antonieta Ramirez-Wakamatzu (Rehabilitation Medicine, Medical Center Aruku) ;
  • Blanca Gabriela Legorreta-Ramirez (Rehabilitation Medicine, Medical Center Aruku)
  • Received : 2024.05.18
  • Accepted : 2024.07.24
  • Published : 2024.09.30
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Abstract

Background: Biopuncture is a described technique that consists in subcutaneous injection of antihomotoxic drugs (homeopathic compounds) mixed with other substances such as local anesthetics or dextrose; This has been proposed as a treatment option to reduce musculoskeletal pain in various locations, including knee osteoarthritis. Objectives: The objective of this manuscript was to carry out a comprehensive review of the published information on the use of Biopuncture in patients with knee osteoarthritis. Methods: A scientific search was performed using online databases following the terms (Biopuncture) and (Knee Osteoarthritis) to identify scientific manuscripts that were related to the use of Biopuncture in the treatment of individuals with knee osteoarthritis. Results: With the information found, a theoretical framework was integrated that describes the components of Biopuncture, its mechanism of action and practical topics for the application of the technique. Conclusion: Biopuncture appears to be a potential, simple and low-risk therapeutic strategy in the treatment of knee osteoarthritis, which is applied through periarticular subcutaneous injections, with multitarget mechanisms of action at various physiopathological levels such as the modulation of the inflammatory process, decreased peripheral sensitization, and stimulation of antidegenerative and trophic mechanisms. Perhaps it can be part of the integrative treatments for knee osteoarthritis.

Keywords

References

  1. Zhang Y, Jordan JM. Epidemiology of osteoarthritis. Clin Geriatr Med. 2010;26(3):355-69. 
  2. O'Neill TW, Felson DT. Mechanisms of osteoarthritis (OA) pain. Curr Osteoporos Rep. 2018;16(5):611-6. 
  3. Arendt-Nielsen L. Pain sensitisation in osteoarthritis. Clin Exp Rheumatol. 2017;35 Suppl 107(5):68-74. 
  4. Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578-89. 
  5. Bruyere O, Honvo G, Veronese N, Arden NK, Branco J, Curtis EM, et al. An updated algorithm recommendation for the management of knee osteoarthritis from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Semin Arthritis Rheum. 2019;49(3):337-50. 
  6. Arias-Vazquez PI, Tovilla-Zarate CA, Legorreta-Ramirez BG, Burad Fonz W, Magana-Ricardez D, Gonzalez-Castro TB, et al. Prolotherapy for knee osteoarthritis using hypertonic dextrose vs other interventional treatments: systematic review of clinical trials. Adv Rheumatol. 2019;59(1):39. 
  7. Arias-Vazquez PI, Tovilla-Zarate CA, Castillo-Avila RG, Legorreta-Ramirez BG, Lopez-Narvaez ML, Arcila-Novelo R, et al. Hypertonic dextrose prolotherapy, an alternative to intra-articular injections with hyaluronic acid in the treatment of knee osteoarthritis: systematic review and meta-analysis. Am J Phys Med Rehabil. 2022;101(9):816-25. 
  8. Arias-Vazquez PI, Tovilla-Zarate CA, Hernandez-Diaz Y, Gonzalez-Castro TB, Juarez-Rojop IE, Lopez-Narvaez ML, et al. Short-term therapeutic effects of ozone in the management of pain in knee osteoarthritis: a meta-analysis. PM R. 2019;11(8):879-87. 
  9. Chen Z, Wang C, You D, Zhao S, Zhu Z, Xu M. Platelet-rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis: a meta-analysis. Medicine (Baltimore). 2020;99(11):e19388. 
  10. Knight B, Walker J, Nair LS. Perineural local anesthetic treatments for osteoarthritic pain. Regen Eng Transl Med. 2021;7(3):262-82. 
  11. Lyftogt J. Subcutaneous prolotherapy treatment of refractory knee, shoulder, and lateral elbow pain. Australas Musculoskelet Med. 2007;12(2):110-2. 
  12. Kersschot J. Biopuncture: the management of common orthopedic and sports disorders. 1st ed. New York: Thieme; 2014. 160 p. 
  13. Kersschot J. Biopuncture: definition and indications in pain management. Eur J Integr Med. 2016;8(S1):5. 
  14. Smit A. [Treatment of musculoskeletal diseases]. Medicina Biologica. 2004;7(2):53-6. Spanish. 
  15. Smit A. [Pain management protocols]. J Biomed Ther. 2004;2:5-7. Spanish. 
  16. Kersschot J. [Biopuncture: protocols for the treatment of chronic inflammatory disorders]. J Biomed Ther. 2008;2(2):10-2. Spanish. 
  17. Schneider C. Traumeel - an emerging option to nonsteroidal anti-inflammatory drugs in the management of acute musculoskeletal injuries. Int J Gen Med. 2011;4:225-34. 
  18. Grech D, Velagala J, Dembek DJ, Tabaac B. Critical literature review of the homeopathic compound Traumeel for treatment of inflammation. Pharmacol Pharm. 2018;9(3):67-83. 
  19. Birnesser H, Stolt P. The homeopathic antiarthitic preparation Zeel comp. N: a review of molecular and clinical data. Explore (NY). 2007;3(1):16-22. 
  20. Keim AP, Slis JR, Mendez U, Stroup EM, Burmeister Y, Tsolaki N, et al. The multicomponent medication lymphomyosot improves the outcome of experimental lymphedema. Lymphat Res Biol. 2013;11(2):81-92. 
  21. del Valle Soto M, Jimenez Diaz F, Manonelles Marqueta P, Ramirez Parenteau C, Rodriguez Vicente JM, Serratosa Fernandez L. [Consensus on the use of infiltration in sport. Document of Consensus of the Spanish Society of Sports Medicine]. Arch Med Deporte. 2016;33(2):114-25. Spanish. 
  22. Kersschot J. [Biopuncture and the treatment of sports injuries]. J Biomed Ther. 2007;1(1):20-2. Spanish. 
  23. Egli S, Pfister M, Ludin SM, Puente de la Vega K, Busato A, Fischer L. Long-term results of therapeutic local anesthesia (neural therapy) in 280 referred refractory chronic pain patients. BMC Complement Altern Med. 2015;15:200. 
  24. Atalay NS, Sahin F, Atalay A, Akkaya N. Comparison of efficacy of neural therapy and physical therapy in chronic low back pain. Afr J Tradit Complement Altern Med. 2013;10(3):431-5. 
  25. Puntillo F, Giglio M, Paladini A, Perchiazzi G, Viswanath O, Urits I, et al. Pathophysiology of musculoskeletal pain: a narrative review. Ther Adv Musculoskelet Dis. 2021;13:1759720X21995067. 
  26. Caracas HC, Maciel JV, Martins PM, de Souza MM, Maia LC. The use of lidocaine as an anti-inflammatory substance: a systematic review. J Dent. 2009;37(2):93-7. 
  27. Cruz FF, Rocco PR, Pelosi P. Anti-inflammatory properties of anesthetic agents. Crit Care. 2017;21(1):67. 
  28. Sung CM, Hah YS, Kim JS, Nam JB, Kim RJ, Lee SJ, et al. Cytotoxic effects of ropivacaine, bupivacaine, and lidocaine on rotator cuff tenofibroblasts. Am J Sports Med. 2014;42(12):2888-96. 
  29. Park J, Sutradhar BC, Hong G, Choi SH, Kim G. Comparison of the cytotoxic effects of bupivacaine, lidocaine, and mepivacaine in equine articular chondrocytes. Vet Anaesth Analg. 2011;38(2):127-33. 
  30. Rabago D, Nourani B. Prolotherapy for osteoarthritis and tendinopathy: a descriptive review. Curr Rheumatol Rep. 2017;19(6):34. 
  31. Wu YT, Wu CH, Lin JA, Su DC, Hung CY, Lam SKH. Efficacy of 5% dextrose water injection for peripheral entrapment neuropathy: a narrative review. Int J Mol Sci. 2021;22(22):12358. 
  32. Weglein AD. Neural prolotherapy. J Prolotherapy. 2011;3(2):639-43. 
  33. Hauser RA, Lackner JB, Steilen-Matias D, Harris DK. A systematic review of dextrose prolotherapy for chronic musculoskeletal pain. Clin Med Insights Arthritis Musculoskelet Disord. 2016;9:139-59. 
  34. Kersschot J. Glucopuncture: a novel injection technique for medically underserved populations. World J Adv Res Rev. 2022;16(2):1-4. 
  35. Porozov S, Cahalon L, Weiser M, Branski D, Lider O, Oberbaum M. Inhibition of IL-1beta and TNF-alpha secretion from resting and activated human immunocytes by the homeopathic medication Traumeel S. Clin Dev Immunol. 2004;11(2):143-9. 
  36. Muller-Lobnitz C. Review of the clinical efficacy of the multicomponent combination medication traumeel and its components. Altern Ther Health Med. 2011;17(2 suppl):S18-31. 
  37. van Haselen R. An integrative review of the evidence on the efficacy of the antihomotoxic medication Traumeel. Pharmacol. 2017;66(3):51-5. 
  38. Jaggi R, Wurgler U, Grandjean F, Weiser M. Dual inhibition of 5-lipoxygenase/cyclooxygenase by a reconstituted homeopathic remedy; possible explanation for clinical efficacy and favourable gastrointestinal tolerability. Inflamm Res. 2004;53(4):150-7. 
  39. Lozada CJ, del Rio E, Reitberg DP, Smith RA, Kahn CB, Moskowitz RW. A double-blind, randomized, saline-controlled study of the efficacy and safety of co-administered intra-articular injections of Tr14 and Ze14 for treatment of painful osteoarthritis of the knee: the MOZArT trial. Eur J Integr Med. 2017;13:54-63. 
  40. Breitinger U, Breitinger HG. Augmentation of glycine receptor alpha3 currents suggests a mechanism for glucose-mediated analgesia. Neurosci Lett. 2016;612:110-5. 
  41. Burdakov D, Jensen LT, Alexopoulos H, Williams RH, Fearon IM, O'Kelly I, et al. Tandem-pore K+ channels mediate inhibition of orexin neurons by glucose. Neuron. 2006;50(5):711-22. 
  42. Han DS, Lee CH, Shieh YD, Chang CT, Li MH, Chu YC, et al. A role for substance P and acid-sensing ion channel 1a in prolotherapy with dextrose-mediated analgesia in a mouse model of chronic muscle pain. Pain. 2022;163(5):e622-33. 
  43. Rezasoltani Z, Taheri M, Mofrad MK, Mohajerani SA. Periarticular dextrose prolotherapy instead of intra-articular injection for pain and functional improvement in knee osteoarthritis. J Pain Res. 2017;10:1179-87. 
  44. Hosseini B, Taheri M, Pourroustaei Ardekani R, Moradi S, Kazempour Mofrad M. Periarticular hypertonic dextrose vs intraarticular hyaluronic acid injections: a comparison of two minimally invasive techniques in the treatment of symptomatic knee osteoarthritis. Open Access Rheumatol. 2019;11:269-74. 
  45. Guzel I, Gul D, Akpancar S, Lyftogt J. Effectiveness of perineural injections combined with standard postoperative total knee arthroplasty protocols in the management of chronic postsurgical pain after total knee arthroplasty. Med Sci Monit. 2021;27:e928759. 
  46. Dhir S, Tureanu L, Bouzari A, Masood A, Francispragasam M, Ganapathy S. Reduction in sodium content of local anesthetics for peripheral nerve blocks: a comparative evaluation of saline with 5% dextrose-a randomized controlled double-blind study. Anesth Analg. 2012;114(6):1359-64. 
  47. Ratiani L, Terunashvili G, Sanikidze T. Antiinflammatory activity of lymphomyosot during chronic deseases. Georgian Med News. 2012;(205):73-82. 
  48. Wu TJ, Lin CY, Tsai CH, Huang YL, Tang CH. Glucose suppresses IL-1β-induced MMP-1 expression through the FAK, MEK, ERK, and AP-1 signaling pathways. Environ Toxicol. 2018;33(10):1061-8. 
  49. Jensen KT, Rabago DP, Best TM, Patterson JJ, Vanderby R Jr. Response of knee ligaments to prolotherapy in a rat injury model. Am J Sports Med. 2008;36(7):1347-57. 
  50. Ahn KH, Kim HS, Lee WK, Kim HW, Yun DH, Kim DH. The effect of the prolotherapy on the injured Achilles tendon in a rat model. J Korean Acad Rehabil Med. 2002;26(3):332-6. 
  51. Park YS, Lim SW, Lee IH, Lee TJ, Kim JS, Han JS. Intra-articular injection of a nutritive mixture solution protects articular cartilage from osteoarthritic progression induced by anterior cruciate ligament transection in mature rabbits: a randomized controlled trial. Arthritis Res Ther. 2007;9(1):R8. 
  52. Kim SA, Kim EH, Kim SY, Lee SY, Yoon JN, Lee YK. The effects of hyperosmolar dextrose and autologous serum injection in the experimental articular defect of rabbit. J Korean Acad Rehabil Med. 2006;30(2):173-8. 
  53. Topol GA, Podesta LA, Reeves KD, Giraldo MM, Johnson LL, Grasso R, et al. Chondrogenic effect of intra-articular hypertonic-dextrose (prolotherapy) in severe knee osteoarthritis. PM R. 2016;8(11):1072-82. 
  54. Kim HJ, Jeong TS, Kim WS, Park YS. Comparison of histological changes in accordance with the level of dextrose-concentration in experimental prolotherapy model. J Korean Acad Rehabil Med. 2003;27(6):935-40. 
  55. Seilheimer B, Wierzchacz C, Gebhardt R. Influence of Traumeel on cultured chondrocytes and recombinant human matrix metalloproteinases: implications for chronic joint diseases. Eur J Integr Med. 2009;1(4):252-3. 
  56. Iglesias-Munoz FJ, Hernandez-Gonzalez LC, Garcia-Mediavilla MV, del Valle Soto M. [The response of articular chondrocytes cultured in vitro under the effects of Zeel T]. Medicina Biologica. 2004;17(3):98-102. Spanish. 
  57. Gottwald R, Weiser M. Treatment of osteoarthritis of the knee with Zeel T. Medicina Biologica. 2000;13(4):109-13. 
  58. Lesiak A, Gottwald R, Weiser M. Effectiveness of the treatment of degenerative joint disease with periarticular, intraarticular, and intramuscular injections of Zeel T. Medycyna Biologiczna. 2001;(2):30-6. 
  59. Testa G, Giardina SMC, Culmone A, Vescio A, Turchetta M, Cannavo S, et al. Intra-articular injections in knee osteoarthritis: a review of literature. J Funct Morphol Kinesiol. 2021;6(1):15. 
  60. Omoigui S, Fadare A. A new minimally invasive procedure for muscle, back, neck pain and radiculopathy - the myofascial nerve block. Ann Clin Case Rep. 2022;7(1):2233. 
  61. Ross JA, Greenwood AC, Sasser P 3rd, Jiranek WA. Periarticular injections in knee and hip arthroplasty: where and what to inject. J Arthroplasty. 2017;32(9S):S77-80. 
  62. Fonkoue L, Behets C, Kouassi JK, Coyette M, Detrembleur C, Thienpont E, et al. Distribution of sensory nerves supplying the knee joint capsule and implications for genicular blockade and radiofrequency ablation: an anatomical study. Surg Radiol Anat. 2019;41(12):1461-71. 
  63. Fischer J. Atlas of injection therapy in pain management. 1st ed. New York: Thieme; 2011. 192p. 
  64. Baars EW. The benefit/risk balance of subcutaneous injections as used in homeopathy and anthroposophic medicine: a narrative literature review. Eur J Integr Med. 2017:15:1-9. 
  65. Abu-Zaid MH, Tabra SA, Elmorsy S. Effect of perineural injection therapy in moderate and severe knee osteoarthritis; a comparative study. Ann Rheum Dis. 2018;77:862-3. 
  66. Maiko OY. Homoeopathic therapy of gonarthrosis with Zeel T. Biologische medizin. 2002;31(2):68-74. 
  67. Maiko O. Time course of changes in the level of C-terminal telopeptides during therapy in patients with osteoarthritis. Vrach. 2016;27(5):36-40. 
  68. Birnesser H, Klein P, Weiser M. A modern homeopathic medication works as well as COX 2 inhibitors. Der Allgemeinarzt. 2003;25(4):261-4. 
  69. Erdem Y, Gul D, Akpancar S. Comparison of intraarticular injections of hyaluronic acid versus dextrose applied with periarticular prolotherapy in the treatment of recreational athletes with knee osteoarthritis. Turk J Sports Med. 2020;55(1):6-13. 
  70. Soliman DMI, Sherif NM, Omar OH, El Zohiery AK. Healing effects of prolotherapy in treatment of knee osteoarthritis healing effects of prolotherapy in treatment of knee osteoarthritis. Egypt Rheumatol Rehabil. 2016;43:47-52. 
  71. Cristales SMA, Arangoz WH. BRIO3 Bioregulatory infiltration therapy with ozone for musculoskeletal pain management, the experience with 229 cases. Ozone Ther Glob J. 2016;6(1):71-8. 
  72. Garnica-Tellez D, Arias-Vazquez PI, Ramirez-Wakamatzu MA. [Efficacy of antihomotoxic medicine in treatment of cervical miofascial syndrome and shoulder girdle: comparative study versus botulinum toxin type A]. Rev Soc Esp Dolor. 2018;25(2):86-93. Spanish.