• 제목/요약/키워드: knee osteoarthritis

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A Systematic Review and Meta-Analysis of Moxibustion Treatment for Knee Osteoarthritis

  • Park, Jang Mi;Lee, Cham Kyul;Kim, Kyung Ho;Kim, Eun Jung;Jung, Chan Yung;Seo, Byung-Kwan;Goo, Bon Hyuk;Baek, Yong Hyeon;Lee, Eun Yong
    • Journal of Acupuncture Research
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    • 제37권3호
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    • pp.137-150
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    • 2020
  • The purpose of this study was to evaluate the evidence supporting the effectiveness of moxibustion treatment for osteoarthritis. There were 9 databases used to retrieve randomized controlled trials (RCTs) that used moxibustion as treatment for osteoarthritis. The quality of methodology for the RCTs was assessed using the Cochrane Risk of Bias tool [Review Manager (RevMan) Version 5.3 Windows, The Nordic Cochrane Centre, Copenhagen, Denmark]. The inclusion criteria for this review was met by 27 RCTs. All studies were conducted in China. A 4-week moxibustion treatment period was the most common. EX-LE4 and SP10 and GB34 acupoints were most frequently selected in the treatment of osteoarthritis. The most commonly used evaluation index was the visual analog scale (VAS). All studies, including a meta-analysis showed that moxibustion treatments were statistically significantly effective at treating knee osteoarthritis. However, well-designed randomized RCTs without a high risk of bias should be designed in the future.

계지가부자탕(桂枝加附子湯)이 MIA로 유도된 골관절염 Rat 모델에 미치는 영향 (Effects of Gyejigabuja-tang on MIA-induced Osteoarthritis in Rats)

  • 원제훈;우창훈
    • 한방재활의학과학회지
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    • 제25권2호
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    • pp.51-64
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    • 2015
  • Objectives This study was carried out to investigate the effects of Gyejigabuja-tang extracts on the Monosodium iodoacetate (MIA) induced osteoarthritis in rats. Methods Osteoarthritis was induced by injection of MIA into knee joint cavity of rats. Rats are divided into 4 groups (normal, control, positive comparison group, GBT group, each n=5). Normal group was injected by normal saline into knee joint cavity only. Control group was induced for osteoarthritis by MIA and oral medicated with distilled water. Positive comparison group was injected with MIA and taken Joins tablet 25 mg/kg. GBT group was injected with MIA and taken Gyejigabuja-tang extracts 300 mg/kg. Positive comparison group and GBT group were oral medicated for each substance once a day for 4 weeks. ALT, AST and creatinine were evaluated for hepatotoxicity and nephrotoxicity. Hind paw weight bearing ability was examined and inflammatory cytokines (IL-$1{\beta}$, IL-6, TNF-${\alpha}$), $PGE_2$, $LTB_4$, osteocalcin and deoxypyridinoline (DPD) within serum were analysed. Knee joint structures were observed by Hematoxylin & Eosin (H&E), Safranin-O staining method. Results 1. Function of liver and kidney was not affected. 2. Hind paw weight bearing ability was significantly improved. 3. IL-$1{\beta}$, IL-6 and TNF-${\alpha}$ in experimental group were significantly decreased compared with control group. 4. $PGE_2$, $LTB_4$, Osteocalcin and DPD in experimental group were decreased compared with control group. 5. In histopathologic observation, injury on synovial membrane and cartilage of experimental group was lesser than control group (H&E, Safranin-O staining). Conclusions Based on these results, it can be suggested that Gyejigabuja-tang has anti-inflammation effects on the MIA-induced osteoarthritis in rats.

기혈소통환(氣血疏通丸)이 Monosodium iodoacetate로 골관절염(骨關節炎)을 유도(誘導)한 랫드에 미치는 영향(影響) (Effects of gihyeolsotong-hwan on monosodium iodoacetate-induced osteoarthritis in rats)

  • 허문강;김순근;최학주;김동희
    • 대한본초학회지
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    • 제33권3호
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    • pp.45-53
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    • 2018
  • Objectives : In cases of osteoarthritis, the hypofunction of the cartilage and joint leads to a limited range of joint motion, swelling, and pain, which is generally treated using pharmaceutical drugs (e.g., anti-inflammatory agents, cartilage protectants, and nonsteroidal anti-inflammatory drugs) or replacement arthroplasty. However, long-term drug treatment is associated with adverse effects on the gastrointestinal systems. The present study aimed to evaluate the ability of Giheolsotong-hwan to treat of osteoarthritis symptoms in the MIA-induced rat model based on histological analysis, and factors that are associated with inflammation and bone mineral metabolism. Methods : Giheolsotong-hwan was administered orally at doses of 200 mg/kg/day or 400 mg/kg/day for 2 weeks before direct injection of monosodium iodoacetate ($3mg/50{\mu}{\ell}$ of 0.9% saline) into the intra-articular space of the rats' right knee. The rats subsequently received the same doses of oral Giheolsotong-hwan for another 4 weeks. We evaluated the treatment effects based on serum biomarkers and histopathological analysis of the knee joints. Results : Compared to those in control rats, the Giheolsotong-hwan treatments significantly decreased the serum concentration of inflammation factors (i.e., $IL-1{\beta}$, IL-6, $TNF-{\alpha}$, $PGE_2$, and $LTB_4$), and bone degrade factors (i.e., MMP-9, CTX-II, and COMP). In addition, the Giheolsotong-hwan treatments significantly increased the concentration of glycosaminoglycans of bone defence factors, but no chage the TIMP-1. Furthermore, the Giheolsotong-hwan treatments effectively preserved the knee cartilage and proteoglycan. Conclusion : The results indicate that Giheolsotong-hwan treated osteoarthritis symptoms. Thus, Giheolsotong-hwan may be a novel oriental therapeutic option for the management of osteoarthritis.

전신진동자극을 동반한 점진적 균형훈련 프로그램이 무릎뼈 관절염 환자의 무릎관절 통증과 기능장애 수준, 심리사회적 수준 그리고 균형능력에 미치는 효과 (Effects of Progressive Balance Training Exercise Programs with Whole Body Vibration on Pain, Function, Psychosocial Status, and Balance in Patients with Knee Osteoarthritis )

  • 윤상우;김선엽
    • 대한물리의학회지
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    • 제19권1호
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    • pp.81-94
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    • 2024
  • PURPOSE: This study aimed to investigate the effect of a progressive balance training program with whole-body vibration stimulation on knee joint pain, dysfunction, psychosocial status, and balance ability in individuals aged ≥ 65 years with knee osteoarthritis. METHODS: A total of 40 individuals aged ≥ 65 years with osteoarthritis of the knees participated in the study. Using a randomization program, participants were assigned to an experimental group (n = 20) or a control group (n = 20). Both groups were assigned a knee strength training program, and a progressive balance training program with whole-body vibration stimulation was assigned to the experimental group. All interventions were conducted three times a week for four weeks. Participants were evaluated for the following: pain (numeric rating scale, NRS), knee dysfunction (Korean version of the Western Ontario and McMaster Universities Arthritis Index, K-WOMAC), fall efficacy (Korean Version Falls Efficacy Scale, K-FES), quality of life (Euro Quality of life 5 Dimension, EQ-5D), and advanced balance scale score (Fullerton advanced balance scale, FAB) before and after the intervention, and the effects of the intervention were compared accordingly between groups. RESULTS: Both groups showed significant differences in the results of the NRS, K-WOMAC, K-FES, and EQ-5D assessments before and after the intervention, and there was a significant difference in the amount of change between the two groups (p < .05). There was a significant improvement in FAB in all but items FAB 8 and FAB 9 after the intervention in the experimental group. In the control group, there was a significant improvement in FAB 1, FAB 2, FAB 7, and FAB total after the intervention (p < .05). In addition, there was a significant difference in the amount of change between the two groups in all items except FAB 8 and FAB 9 (p < .05). CONCLUSION: The progressive balance training program with whole body vibration stimulation is an effective intervention method with clinical significance in improving knee joint pain, knee disability index, psychosocial level, and balance ability in adults aged ≥ 65 with osteoarthritis of the knees.

밀착형 외측 쐐기 스트랩 깔창의 높이에 따라 하지의 근활성도에 미치는 영향 (Effects of Muscle Activity of Lower Extrimity with Contact Laterally Wedged Insoles with Strapping of Varying Elevations)

  • 이상용;배성수;공원태
    • 대한물리의학회지
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    • 제1권1호
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    • pp.37-47
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    • 2006
  • Purpose : The purpose is to assess the effects of muscle activity of normal person with contact laterally wedged insoles with strapping of varying elevations of 9, 15, 21mm. Methods : The subjects were adult males and women who had not experienced any knee injury. They were asked to performed from isometric contraction exerciese in four postures using lateral wedged. The normalized EMG activity levels(%MVC) of the vastus lateralis, vastus medialis, tibialis anterior, soleus for the four postures of the lower extremities were compared using one way repeted measures ANOVA. Results : Comparison of EMG amplitudes across all postures revealed no significant differences among all muscles(P>0.05). Conclusion : Further studies of the effect of wedged insole angle on knee varus torque in patients with medial-lateral knee osteoarthritis are needed.

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대강활탕(大羌活湯)이 흰쥐에서 MIA로 유발된 골관절염에 미치는 항염증 및 연골 보호 효과 (Anti-inflammatory and Cartilage Protection Effects of Daeganghwal-tang in MIA-induced Osteoarthritis at Rats)

  • 김주란;이정희;이윤규;이현종;김재수
    • 대한한의학방제학회지
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    • 제29권3호
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    • pp.127-145
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    • 2021
  • Objectives : The purpose of this study was to evaluate the effects of Daeganghwal-tang on knee cartilage in monosodium iodoacetate(MIA)-induced osteoarthritis rats. Methods : Forty SD rats were randomly divided into five groups(n=8/group): normal group was SD rats group injected with normal saline at left knee joint and administrated orally distilled water, control group was MIA-induced osteoarthritis SD rats group administrated orally distilled water, Indomethacin group was MIA-induced osteoarthritis SD rats group administrated orally indomethacin 2 mg/kg, DGHT(L) group was MIA-induced osteoarthritis SD rats group administrated orally 1280 mg/kg of Daeganghwal-tang, and DGHT(H) group was MIA-induced osteoarthritis SD rats group administrated orally 2560 mg/kg of Daeganghwal-tang. After orally administration of drugs for 4 weeks, gross appearance and histological analysis were used to evaluate the degree of knee cartilage damage. In addition, pro-inflammatory cytokines, bone degrade factor and bone defence factors were analyzed to investigate the anti-inflammatory and cartilage protection effects of Daeganghwal-tang. Also, hematological test, biochemical test, and liver and kidney tissue were analyzed to determine the safety of Daeganghwal-tang. Results : Daeganghwal-tang inhibited the damage of the knee cartilage, and significantly prevented the reduction in cartilage thickness. In addition, the pro-inflammatory cytokines and the bone degrade factor significantly decreased, and the bone defence factors significantly increased. In the safety assessment of Daeganghwal-tang, there were no significant differences among the experimental groups and no abnormal findings were observed. Conclusions : Daeganghwal-tang has anti-inflammatory effect, inhibits cartilage damage, and protects cartilage in MIA-induced osteoarthritis rats.

Effects of Korean Traditional Medicine Treatment on Spontaneous Osteonecrosis of the Knee: A Case Report

  • Lee, Soo-Kyung;Park, Eun-Young;Lee, June-Haeng;Kang, Sun-Woo;Won, Yoon-Jae;Yang, Myeong-Yeol;Ha, Jae-Joon
    • Journal of Acupuncture Research
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    • 제39권1호
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    • pp.59-63
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    • 2022
  • Spontaneous osteonecrosis of the knee (SONK) is a common form of osteonecrosis of the knee and mainly affects the medial condyle due to localized vascular insufficiency. We report a case of SONK in a 65-year-old woman who had severe knee pain in her left knee whichimpeded her capacityto walk beyond 10 minutes. Bilateral knee X-rays revealed degenerative osteoarthritis of both knees and magnetic resonance imaging revealed R/O SONK in the lateral aspect of the medial femoral condyle, as well as a medial meniscal posterior horn root tear, and a Grade 1 medial collateral ligament injury. She was hospitalized at Jaseng Hospital of Korean Medicine for 21 days and receivedcombination therapy includingacupuncture, pharmacopuncture, and herbal medicine. Patient-reported scales indicated that her pain and physical functional limitations were alleviated. Combination therapy consisting of Korean traditional medicine may bean alternative nonoperative treatment approach for patients with SONK.

중증 족관절 관절염: 족관절 전치환술 (Severe Ankle Osteoarthritis: Treatment with Total Ankle Arthroplasty)

  • 정비오;정혁
    • 대한족부족관절학회지
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    • 제22권1호
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    • pp.8-15
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    • 2018
  • Ankle osteoarthritis is a debilitating condition that causes severe pain associated with functional impairment and decreased activity. Ankle osteoarthritis, unlike that of the knee or hip joint, is rare in primary arthritis. Most cases are traumatic arthritis that occur after ankle sprain or fractures or chronic ankle instability. Although ankle fusion has been regarded as the standard treatment of ankle osteoarthritis in the past, total ankle arthroplasty (TAA) is increasing due to the development of the implant design and surgical techniques. TAA is biomechanically superior to ankle fusion by preserving the movement of the ankle joint. In particular, it is functionally superior to ankle fusion because it enables normal joint motion during gait. In addition, there is an advantage of preserving the movement of the hindfoot and reducing the abnormal stress applied to the adjacent joints after ankle fusion to prevent the occurrence of long-term adjacent joint arthritis. Although the short-term and mid-term results of TAA have been reported to be excellent, long-term follow-up has a relatively low survival rate and high complication rate compared to total knee or hip arthroplasty. Therefore, continuous and further research is needed.

퇴행성 슬관절염에 대한 근위취혈과 원위취혈 침 치료의 효과 비교에 대한 임상연구 (A Randomized Clinical Trial of Local Acupoints Compared with Distal Acupoints in Degenerative Osteoarthritis on Knee)

  • 박인식;정찬영;장민기;강미숙;이승우;김은정;이승덕;김갑성
    • Journal of Acupuncture Research
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    • 제25권2호
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    • pp.227-242
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    • 2008
  • Objectives : To compare the efficacy of local acupoint with distal acupuncture at relieving pain and improving function in knee osteoarthritis. Designs : A randomized, single-blinded, crossover clinical trial. Settings : One outpatient clinic(department of acupuncture & moxibustion) located in academic teaching hospital, South Korea. Patients : 17 patients with osteoarthritis of the knee(mean age 62.76[$SD{\pm}4.37$] years). Interventions : The trial had 4 stages : baseline(2weeks), phase I and II(each 2weeks), washout period(2weeks). Patients were randomly assigned to either group A or group B. Group A received acupuncture at local acupoints during phase I, then acupuncture at distal acupoints in phase II. Group B received the treatments in reverse order. In each phase, the patients were treated with acupuncture for 6 times. Measurements : The primary outcome was subjective pain as measured by a 100mm visual analogue scale(VAS) ranging from 0(no pain) to 10(worst pain ever). Secondary outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC) total and pain scores. Measurements were obtained at baseline, 1st day of phase I and II, and 2 days after last treatment of phase I and II. Results : The 17 participants in 2 groups were well matched for age, sex, target knees, baseline VAS score, WOMAC pain score and WOMAC score. Participants in local acupoint group experienced greater improvement than distal acupoint group at 2 days after last treatment in WOMAC total score(mean difference, -10.65[95% CI, -20.56 to -0.74] ; P=0.036) but not in VAS(mean difference, -12.41[95% CI, -29.56 to 4.73] P=0.15) and WOMAC pain score(mean difference, -1.82[95% CI, -3.98 to 0.33] ; P=0.094). Conclusions : Local acupoints are more effective than distal acupoints at relieving pain and improving function in knee osteoarthritis.

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구판(龜板)약침이 여성의 퇴행성 슬관절염에 미치는 영향 (The Effect of Chinemys reevesii Gray Pharmacopuncture for Women with Knee Osteoarthritis)

  • 신소연;서동균;김신영;서종철;서연주;이윤주;빈창현;정택근;송춘호;윤현민;김철홍;장경전
    • Journal of Acupuncture Research
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    • 제32권3호
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    • pp.163-173
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    • 2015
  • Objectives : The aim of this study is to determine whether Chinemys reevesii Gray pharmacopuncture is a clinically effective treatment for women with knee osteoarthritis. Methods : Female patients with knee osteoarthritis were recruited from May $1^{st}$, 2014 to April $15^{th}$, 2015 at the Department of Acupuncture & Moxibustion Medicine of Dong-Eui University Korean Medical Hospital. Patients were randomly assigned to two groups. 4.0 ml of Chinemys reevesii Gray pharmacopuncture was injected at acupuncture points of the experimental group(n = 24) twice a week for three weeks. The control group(n = 24) received 5 % dextrose injections in order to identically stimulate the same acupuncture points of $ST_{35}$, $ST_{34}$, $SP_9$, $SP_{10}$, $GB_{34}$, $LR_8$, $EX-LE_4$, and $EX-LE_2$. The Short-Form McGill Pain Questionnaire(SF-MPQ), the Korean Western Ontario and McMaster Universities Osteoarthritis Index(KWOMAC), and the European Quality of Life-5 Dimensions(EQ-5D) were recorded to evaluate treatment efficacy at first visit, after two weeks and four weeks from the initial visit. Results : 40 patients completed the trial. The experimental group showed more significant improvement than the control group in the scores of SF-MPQ, KWOMAC, and EQ-5D. However, there was no significant difference between groups in a few of the assessment scales. Conclusions : Chinemys reevesii Gray pharmacopuncture can be an effective treatment in control of pain, improvement in function and health-related quality of life for women with knee osteoarthritis.