超声引导针刀松解膝结筋病灶对膝骨关节炎的临床研究OA

Objective:To observe and compare the clinical efficacy and safety of ultrasound-guided acupotomy releasing myofascial lesion points versus conventional target points in treatment of knee osteoarthritis(KOA).Methods:A total of 48 patients with KOA were randomly divided into the myofascial lesion group and the conventional target group,with 24 patients in each group.In the myofascial lesion group,acupotomy insertion points were selected based on traditional meridian tendon theory,including Hedingci,inferolateral patella,and inferomedial patella.In the conventional target group,insertion points were selected according to the Clinical Diagnosis and Operation Standards of Acupotomy Therapy,including quadriceps tendon insertion,patellar ligament origin,medial and lateral collateral ligaments,medial and lateral patellar supporting bands,and pes anserinus tendon.All procedures were performed under ultrasound guidance.Treatment was administered once per week,with two sessions constituting one course,for a total of two courses.The scores of VAS and WOMAC,and knee synovitis changes,including effusion depth,synovial thickness,and blood flow signal grade were recorded at baseline,1 week,and 4 weeks after the treatment.Clinical efficacy was compared between the two groups.Results:Compared with pretreatment,both groups showed significant reductions in the scores of VAS and WOMAC after the treatment(P＜0.05),as well as significant decreases in effusion depth,synovial thickness,and blood flow signal grade(P＜0.05).Compared with the conventional target group,the myofascial lesion group demonstrated lower VAS and WOMAC scores,and greater reductions in effusion depth,synovial thickness,and blood flow signal grade(P＜0.05).No serious adverse reactions were observed in either group.The total effective rate was 95.65％(22/23)in the myofascial lesion group,which was higher than 90.91(20/22)in the conventional target group,and there was no statistical difference between the two groups(P＞0.05).Conclusion:Ultrasound-guided acupotomy releasing Hedingci,inferolateral patella,and inferomedial patella myofascial lesion points demonstrates superior effects compared with conventional target points in improving periarticular microcirculation,alleviating inflammatory manifestations,protecting cartilage tissue,and regulating knee joint function in patients with KOA.This therapy significantly relieves clinical symptoms and offers better long-term outcomes,supporting its clinical promotion and application.