| ObjectiveUsing stochastic comparison, this study objectively evaluates the clinical effectiveness and safety of chiropractic treatment of osteoarthritis of the knee of spinal origin.MethodThe subjects of this study, a total of 60, were selected from patients with osteoarthritis of the knee of spinal origin who sought treatment at the Dong Hai Tui Na Bao Jian Clinic in Hong Kong between January 2009 and December 2010. Patients were screened for the study according to uniform standards of diagnosis, selection and rejection. Tests were carried out using stochastic comparison. That is, based on the time of registration for treatment, qualified patients were alternately assigned to a treatment group and a control group for a total of 30 members each. Chiropractic treatment was applied to patients in the treatment group, and traditional acupressure treatment was applied to patients in the control group.For both groups, a course of treatment for a patient was three 40-minute sessions a week for a total of 15 sessions. Clinical effectiveness of the treatment was assessed by evaluating before and after a course of treatment the following indices:(a) the Lequesne MG Index of Severity for OA (Table 1); (b) the WOMAC (Canada) Index of OA based on clinical symptoms; and (c) the Four Point Scale of Joint Tenderness.The sustainability of effectiveness of treatment for each patient was assessed at a follow-up visit 15 days after the end of a course of treatment. The patient was also examined for any undesirable effects of treatment.Results1. Prior to treatment, the corresponding indices of the two groups have no significant difference (P> 0.05), that is, they were comparable. Lequesne MG Index of Severity for OA before treatment:7.03±3.23 for the treatment group and 7.53±3.00 for the control group. WOMAC Index of OA before treatment: 20.77±12.75 for the treatment group and 22.07±12.93 for the control group. Four Point Scale of Joint Tenderness before treatment:87 for the treatment group and 87 for the control group.2. There were significant intra-group differences in the indices after treatment (P<0.01) for the two groups. There were also significant inter-group differences in the corresponding indices after treatment (P< 0.05). Lequesne MG Index of Severity for OA after treatment:2.70±3.17 for the treatment group and 3.50±3.54 for the control group (P<0.05). WOMAC Index of OA after treatment:8.77±10.60 for the treatment group and 12.57±12.12 for the control group (P<0.01).Four Point Scale of Joint Tenderness after treatment:58 for the treatment group and 68 for the control group (P<0.05). These results showed that chiropractic treatment of osteoarthritis of the knee of spinal origin was more effective in reducing knee joint pain, alleviating the severity of knee arthritis and improving knee joint function.3. For the treatment group, the clinical cure rate was 33.33%, while the rate of effectiveness was 96.70%. For the control group, the clinical cure rate was 20.00%, while the rate of effectiveness was 80.00%. Chi-square tests shows that while there was no significant difference between the two groups in the cure rate (P>0.05), there was a significant difference in the rate of effectiveness (P<0.05), with the treatment group performing better than the control group.This indicated that chiropractic treatment was significantly more effective than traditional acupressure treatment for osteoarthritis of the knee of spinal origin.4. For all 60 patients, there was no significant difference (P>0.05) between the effectiveness of treatment at the end of a course of treatment (15 sessions) and the effectiveness at the follow-up visit 15 days later, indicating that the sustainability of effectiveness of treatment was comparable for the two groups.ConclusionChiropractic treatment of osteoarthritis of the knee of spinal origin has shown to be quite clinically effective and scientific, and is worth promoting.
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