A Case-control Study On The Treatment Of Pain Caused By Early Patellofemoral Arthritis By Regulating Tendons And Lifting Patella

OA,also known as degenerative joint disease,senile arthritis,proliferative arthritis,hypertrophic arthritis,osteoarthritis,cartilage softening arthropathy,bone hyperplasia,etc.Commonly seen in the clinic are rheumatic diseases after middle age In 1994,a concise definition of osteoarthritis was made at the American Osteoarthritis Symposium:Osteoarthritis is a group of diseases with different causes but some similar morphology,biology,and clinical manifestations.The disease not only causes articular cartilage damage,but also affects the joint capsule,synovium,subchondral bone,ligaments,and surrounding muscle tissue,which eventually leads to the degeneration,fibrosis,rupture,and ulceration of the articular cartilage,up to the entire articular surface Was damagedKOA,Chinese medicine called knee arthritis,refers to when the body's righteousness is insufficient,it is attacked by external evils such as wind,cold,dampness,heat,etc.,or the body produces phlegm and stasis.There is a kind of disease syndrome characterized by knee joint pain,swelling,numbness,weight loss,flexion and extension activities,even joint deformation,disuse,and muscle atrophy.The knee joint is composed of the patella,the lower end of the femur and the upper end of the tibia.It is the largest and most complex joint of the human body and belongs to the pulley joint.Knee surgery usually divides the knee joint into three parts:medial femoral tibial joint,lateral femoral tibial joint,and patellofemoral joint,of which osteoarthritis occurs most in the patellofemoral joint.PFOA is a very common degenerative disease in orthopedics clinics.China has a large population base.With the aging of society,the incidence of the disease is high,which will seriously affect the knee flexion and extension function.As a result,the quality of life of patients is reduced.Therefore,it is of great significance to find a simple,convenient,inexpensive,and experimental treatment plan for traditional Chinese medicineThe early onset of patellofemoral arthritis is mainly pain,which affects the knee movement and walking function of the patient.As the disease progresses,it can be manifested as changes in the shape of the knee joint,and even difficulty walking Therefore,early diagnosis and early treatment are very important,and the relief of pain caused by disease is also the first.Treatment of early patellofemoral arthritis pain,including brake rest,plaster external application,non-steroidal anti-inflammatory drugs(NSAIDs)oral,sodium hyaluronate joint puncture and closed treatment,acupuncture,moxibustion,massage manipulation and physical therapy are also certain Effect,but the effect is difficult to discernIn the previous clinical research,our hospital found that the treatment of early patellofemoral arthritis pain by using the tendon lifting method is good.The treatment focuses on the "ribs" around the knee joint.The bones are treated by the tendons,and the tendons are relaxed.It can benefit the joints and the bone disease is cured,but the related operation has not been standardized,and its mechanism of action is not clear Therefore,this study intends to use the networked central random system under the guidance of the concept of "both muscles and bones" to conduct a randomized clinical controlled study to further improve the operation rules of treating muscles and patella to treat early patellofemoral arthritis pain.Compared with sodium hyaluronate injection,we summarize and analyze the respective indications and advantages of the two treatment methods of knee joint internal and external.The innovations of this research are:(1)Analyze the characteristics of "points" and "faces" of patellofemoral arthritis pain from the overall joint:the onset of patellofemoral arthritis starts from the point,through the points and the face,the highest point of soft tissue tension during treatment(Tendons)Plucking and tapping techniques are used to reduce stress and release,release the excessive pressure of the fascial cavity,restore the function of the bones and joints to normal with the change of stress,achieve soft tissue balance,reduce or eliminate pain,and slow down the patella The development of arthritis From the point of view of treatment,to a small broad,to reflect the change in the cognitive model of disease.Accurately grasp the relationship between points and surfaces in the course of treatment,and establish a treatment plan under the guidance of the concept of "muscles and bones" in traditional Chinese medicine;(2)The transformation from "bone disease to treat bones" to "strengthen bones to treat bones" reflects the innovation of the treatment concept:the concept of "equal emphasis on muscles and bones" is incorporated into the prevention and treatment of patellofemoral arthritis,to achieve the transformation of diagnosis and treatment thinking and solve the early The harmonious relationship between the tendons and bones of the pain of patellofemoral arthritis has changed the traditional thinking of bone treatment in the past.Based on the theory of "ribs and bones" in traditional Chinese medicine,it pays attention to the physiological synergy of tendons and bones in the treatment process.1 Research purposeUnder the guidance of the concept of "both muscles and bones",based on previous clinical experience,the literature of patellofemoral arthritis is used for reference,the characteristics of patellofemoral arthritis pain are analyzed,combined with the theory of traditional Chinese medicine meridian theory,the analysis of tendons and patella maneuvers Indications and theoretical basis for the treatment of patellofemoral arthritis pain,through a clinical randomized controlled study,a set of standardized treatment plans for the treatment of patellofemoral arthritis pain by summing up tendons and lifting patella were summarized,and its clinical effect and advantages were evaluated2 Materials and methodsThis study is a clinical randomized controlled study,all cases come from the outpatient department of our hospital.Randomized grouping was conducted using a networked central random system to conduct a randomized clinical controlled study 60 patients who met the inclusion criteria were divided into a test group and a control group through a random system.Each group of 30 patients was treated with Lijin and patella maneuver,Sodium hyaluronate joint puncture treatment.The treatment and follow-up period is 5 weeks.According to the patient's condition,according to the patient's pain points,the experimental group was treated once a week,5 weeks as a course of treatment;the control group was treated with sodium hyaluronate conventional medication,once a week,5 weeks as a course of treatment.The observation period of this study is 1 course of treatment.Joint pain(VAS score),local pain point tenderness measurement,knee mobility evaluation,Lysholm knee score and overall efficacy evaluation criteria were used as evaluation indicators to evaluate the knee function of patients before treatment and after the fifth treatment.3 Research resultsThe two groups of patients were compared in nine aspects including gender,age,body mass index,side of the knee,course of disease,VAS score before treatment and local pain point tenderness measurement,knee mobility,Lysholm knee score,P>0.05,no difference Statistically significant and comparableThrough clinical treatment and observation and follow-up,the two groups of patients have achieved good therapeutic effects.The clinical evaluation indicators are as follows:(1)Comparison before and after treatment:After 5 treatments in two groups,the VAS score,local pain point tenderness measurement,knee joint mobility and Lysholm knee joint score were better than before treatment(P<0.05);(2)After the fifth treatment,the clinical observation indexes of the two groups were compared:? VAS score:1.80 ± 1.00 in the test group,1.70± 0.79 in the control group,P=0.669>0.05,the difference was not statistically significant,there was no significant difference between the two groups;?Determination of local tenderness:the test group was 2.13±0.32,the control group was 2.03±0.22,P=0.023<0.05,the difference was statistically significant,considering that the local pain relief of the test group was better than the control group;?Knee joint mobility:131.30±7.51 in the test group,128.50 ± 6.20 in the control group,P=0.000<0.05,the difference is statistically significant,and the joint mobility in the test group is better;? Lysholm knee score:80.30± 5.30 in the test group and 77.77±4.80 in the control group,P=0.057>0.05,the difference was not statistically significant,and there was no significant difference between the two groups;(3)Overall efficacy evaluation:86.67%in the test group and 83.33%in the control group.The total effective rate of the two groups of patients is basically the same.4 ConclusionUnder the guidance of the concept of "both muscles and bones",the use of ligaments and patella lifting techniques to treat early patellofemoral arthritis has a good clinical effect,can improve knee flexion and extension function,and clearly reduce the pain of patients.,It has the advantages of easy acceptance by patients and has high application value.