The Study Of Symptoms In Knee Osteoarthritis And It's Correlation With Pathological Change In X-ray

Knee osteoarthritis (KOA) belongs to osteoarthritis. KOA is a kind of chronic progressing arthritis disease, which is also called knee hyperplasia arthritis, retrogressive arthritis, hypertrophic arthritis, and retrogressive osteoarthritis. Its main clinical manifestation is progressing chronic arthralgia, rigidity, tumidness accompanied with movement restriction, which leaded to dysfunction of the knee joint, even deformity in severe cases. It' s one of the main reasons of elders'joint ache and disability. In traditional Chinese Medicine, KOA was classified into Gubi or Jinbi, and its pattern of syndrome usually divided into three:deficiency of kidney-Qi and marrow, deficiency of Yang—Qi accumulation of cold, and blood stasis in Jingu. X-ray examination is the essential basic clinical examination for KOA. But the clinical symptoms of KOA and the pathological change in X-ray were sometimes not usually consistent:clinical syndrome indicated KOA, but X-ray shows little or none changes of knee joint, or there are obvious X—ray changes in some cases, but found none of KOA syndromes.ObjectivesTo explore symptoms in knee osteoarthritis and it's correlation with pathological change in X-ray, and to study the clinical effects of comprehensive therapy of TCM in treating KOA.MethodsWe investigated 250 cases those with knee osteoarthritis from the clinic of Traumatic and Orthopedics hospital affiliated to Guangzhou University of TCM and the second Orthopedics department of Jiangmen Wuyi hospital. The study was devided into two parts:First, those with synovitis 110 cases were treated with Method One:sicken knee movement restriction; take Chinese Medicine Xiao Zhong Fang; external applicated with Sihuang Gao; those seriously swelling treated with arthrocentesis. Compare the clinical effects before and after the treatment, to learn the differences between those with bone hyperplasia and those not with bone hyperplasia. Second, the rest 140 cases not with synovitis were treated with Method Two:Chinese herbal fumigation and washing; external applicated with Shujinhuoluo Gao; take Chinese Medicine Bugu Fang; those cases wirh serious medial collateral ligament pain, used block therapy. Analysis the Chinese syndrome type and study the correlation between the symptoms and the pathological change in X-ray. Use the WOMAC score before and after the treatment to annlysis the clinical results. Use the SPASS 13.0 data pack to annlysis the correlations among datas, clinical results, and X-ray changes.ResultFirst, there is some kind of correlation between the clinical results of 110 cases with synovitis and the pathological change in X-ray:those bone hyperplasia degree 2-4 had better clinical effect than those bone hyperplasia degree 0-1. Synovitis usually had been found in obivious patella and tibial carina hyperplasia.Second, in 140 cases which not with synovitis, blood stasis in Jingu was the main Chinese pattern of syndrome. All of the 140 cases had excellent clinical result after comprehensive therapy of TCM, especially those deficiency of Yang—Qi accumulation of cold.Third, this study had shown that there were obvious ccorelation between the places where the bone hyperplasia occurred and local pain:patella and local pain usually found in patella hyperplasia; medial collateral ligament pain usually seen in medial tibial hyperplasia; knee pain when up and down stairs usually found in patella hyperplasia; rest pain seen in bone hyperplasia degree 1-2.ConclusionsFirst, there is some kind of correlation between the clinical results of 110 cases with synovitis and the pathological change in X-ray:those bone hyperplasia degree 2-4 had better clinical effect than those bone hyperplasia degree 0-1. This indicates synovitis in knee osteoarthritis has something to due with the degree of bone hyperplasia.Second, the location and the degree of bone hyperplasia has obvious ccorelation with local pian and the form of pain.Third, most of the syptoms of knee osteoarthritis which induced by bone hyperplasia had been improved after comprehensive therapy of TCM. This shows comprehensive therapy of TCM is a good therapy for knee osteoarthritis.