Knee Arthroscopy Combined With Heat-sensitive Moxibustion In The Treatment Of Knee Osteoarthritis

Objective:To observe and evaluate the effect of heat-sensitive moxibustion on the functional recovery and symptom improvement of knee osteoarthritis after arthroscopy.Methods:From September 2018 to October 2019,60 patients in 40-70 years with knee osteoa rthritis were selected from the second Department of orthopedics,Dongzhimen Hospital Beijing University of Chinese Medicine and randomly divided into two groups,30 in t he observation group and 30 in the control group.The patients in the observation grou p were treated with heat-sensitive moxibustion for two weeks after removing the sutur e one week after arthroscopy.Another was not given special treatment.Both of groupsw ere followed up by 3 months.Lysholm scale and WOMAC scale were used to score at preoperation,third week after operation and third month after operation respectively.An d then,the recovery of lower knee function and symptom improvement of the both gro ups were compared,evaluated and analyzed by the score results.The X-ray positive film s of weight-bearing position of the knee were taken in 15 patients in the two groups at first week and third month after operation respectively.According to the changes of the tibiofemoral joint space,thecartilage injury was evaluated and the results were analy zed,and then,the effect of heat-sensitive moxibustion on the postoperative effect of arth roscopy in patients with different types of TCM syndrome was evaluated by the differ ences and changes of postoperative scores of patients with different types of TCM syn drome in the observation group.Results:There was no significant difference in Lysholm score and WOMAC score between the pre-operative control group and the observation group(P>0.05).At third week and third month after operation,Lysholm score of the control group was(59.90±5.33)and(70.57±10.60),the observation group was(71.87±9.63)and(80.47±11.33).The WOMAC score of the control group was(21.23±5.94)and 12.5(9-17),and observation group was(15.17±4.66)and 8.5(7-13),respectively.The Lysholm score and WOMAC score at that time were improved,and at the observation group improved more than the control grou p,the difference between the two groups was statistically significant(P<0.05).There was no significant difference in the score of pain,stiffness and joint dysfunction between th e two groups(P>0.05)before the operation,and no significant difference in the score of stiffness between the two groups(P>0.05)at third month after the operation,but the score of pain and joint dysfunction in the observation group was better than that in th e control group(P<0.05).At first week after the operation,the joint space of the two groups was(3.87±0.59)mm and(3.87±0.59)mm respectively.At the third week after t he operation,the joint space of the.two groups was(3.63±0.55)mm and(3.79±0.55)m m.There was no significant difference between the two groups(P>0.05)at first week and third month.After treatment,the overall rate of excellent knee joint function was 62%,40%in the control group and 83%in another group.There was no significant difife rencein Lysholm score among different types of syndrome before operation(P>0.05),bu t Lysholm score(81.11±8.3 6)of cold dampness obstruction type was higher than that ofother types of syndrome at third week after operation and the difference was statisti cally significant(P<0.05).However,there was no significant difference in other types of syndrome(P>0.05).At the third month after operation,the Lysholm score of cold damp ness obstruction type was(90.11±10.90),the liver kidney deficiency type was(81.36±6.61),the difference between the two groups was not statistically significant(P>0.05),but the score was higher than that of Qi blood weakness type and qi stagnation blood sta sis type,and the difference was statistically significant(P<0.05).There was no significan tdifference in WOMAC score between different TCM syndromes at the same time bef ore and after operation(P>0.05).Conclusion:Heat-sensitive moxibustion can effectively improve the curative effect of knee oste oarthritis after arthroscopy,enhance the knee joint dysfunction of patients,and improve t he symptoms of knee osteoarthritis,especially the pain and joint activity function.Theref ore,it is better to use heat-sensitive moxibustion as adjunctive therapy to treat kneeoste oarthritis,especially the cold dampness obstruction type occupies fist place,deficiency of liver and kidney comes second.