Clinical Research On The Treatment Of Early And Mid-stage Patellofemoral Arthritis Based On The "meridian And Tendon Theory" Pressing Acupuncture Combined With The Tendon-lifting Patella Manipulation

1 ObjectiveUnder the guidance of the aponeurotic system,a clinical randomized controlled trial was made to improve the operational details of Thumb-tack intradermal needle combined with manipulation in the treatment of patellofemoral osteoarthritis,to evaluate the clinical effectiveness of Thumb-tack intradermal needle in the treatment of patellofemoral osteoarthritis and to compare the advantages of manipulation alone.The clinical outcomes of the treatment of patellofemoral osteoarthritis with acupuncture and the advantages of manipulation alone were evaluated.Based on the clinical results,he imaging indices of patellofemoral joint disorders,the possible mechanisms and clinical significance of pain and limitation of movement in patellofemoral osteoarthritis treated with the aid of acupuncture were analysed to provide a reference for the clinical treatment of aponeurotic system with Thumb-tack intradermal needle.2 Materials and methodsThis study was a single-centre randomised controlled trial,with cases sourced from the outpatient and inpatient departments of Wangjing Hospital.A random number table was used to randomly divide 80 patients with patellofemoral osteoarthritis who met the inclusion criteria into a test group and a control group,40 patients in each group;axial imaging data of the knee joint in both groups were collected before the trial.The test group was treated with Thumb-tack intradermal needle and manipulation,while the control group was treated with manipulation.The treatment period was 1 month,and VAS score and Lysholm knee function score were recorded according to 3 observation points:before treatment,after 2 weeks of treatment and after 1 month of treatment.SPSS 22.0 software was applied to process the data to compare the overall efficacy.3 ResultsThere were no statistical differences in the general conditions of the two groups before treatment,such as age,gender,duration of disease,body mass index,affected side and K-L classification;there were also no differences in the observed indicators before treatment,such as VAS scores,Lysholm knee scores and imaging indicators of patellofemoral disorders(ps>0.05).Through the 1-month clinical treatment and follow-up,the two groups were compared in terms of clinical evaluation indexes as follows.3.1 Comparison before and after treatment:the VAS scores and Lysholm scores of patients in both groups at 2 weeks and 1 month of treatment were significantly improved compared with those before treatment(ps<0.05);at 2 weeks and 1 month of treatment,the improvement in knee function in the test group was better than that in the control group(ps<0.05).3.2There was a significant negative correlation between the pre-treatment Lysholm score and Insall's index,patellofemoral index,patellofemoral coordination angle and patellofemoral tilt angle,and a positive correlation with the lateral patellofemoral angle.3.3There was a significant negative correlation between the treatment effect and patellofemoral function before treatment in both groups;there was a significant positive correlation between the treatment effect and patellofemoral index,patellofemoral coordination angle and patellofemoral tilt angle in the test group;there was a significant positive correlation between the treatment effect and patellofemoral tilt angle in the control group.3.4 There was no significant difference in the overall efficacy between the test group and the control group,but the test group had a high excellent rate.The overall effective rate was 97.5%in the test group and 90.0%in the control group,the difference was not significant and the two groups were basically the same;the excellent rate of 45.0%in the test group was better than that of 30.0%in the control group.4 Conclusion4.1 The treatment of patellofemoral osteoarthritis by Thumb-tack intradermal needle with manipulation can effectively improve the clinical efficacy,increase the cure rate and overall efficiency,and is safe without adverse effects.4.2 In the axial radiographs of the knee joint,some of the imaging indicators of patellofemoral disorders had a simple correlation with the knee joint score,which could reflect the severity of patellofemoral disorders:the patellofemoral coordination angle,patellofemoral tilt angle,patellofemoral index and Insall index had a significant negative correlation with the knee joint score,while the lateral patellofemoral angle showed a positive correlation with the knee joint score.4.3This trial also found a significant positive correlation between patellofemoral tilt angle and patellofemoral osteoarthritis' treatment,and it can be used as an important indicator to predict the prognosis of the disease.