Effects Of Acupotomy Intervention On Bone Marrow Edema And Intramedullary Hemorheology In The Tibia In KOA Rabbit Mode

BackgroundKnee osteoarthritis(KOA)is a common osteoarthritis that seriously affects human health,causing pain,functional limitations and even psychological disorders such as anxiety and depression.According to a recent cross-sectional study,KOA patients are prone to depression,and pain symptoms of KOA are one of the determinants of depression.Currently,biomechanical intervention can effectively alleviate the progress of KOA disease,and acupotomy therapy is one of the effective methods of biomechanical intervention,which has been widely accepted by doctors and patients.Acupotomy therapy can quickly relieve pain and reduce KOA symptoms.Meanwhile,it has the advantages of simple operation,short course of treatment and optimal treatment with minimal trauma.The curative effect of acupotomy on KOA is definite.In-depth research on mechanism of acupotomy therapy is conducive to the promotion of acupotomology in the treatment of KOA,which is of great significance for reducing the burden on families and society.Previous studies have found the mechanism of Tendon Regulation and Bone Treatment with acupotomy therapy for KOA,by intervening the quadriceps,acupotomy can exert analgesic and anti-inflammatory effects,recuperate the mechanical imbalance of knee joint,relieve the abnormal stress on the cartilage surface,and alleviate the cartilage degeneration,which is the core advantage of acupotomy therapy for KOA.Existing studies have found that bone marrow edema and hemorheological abnormalities can accelerate KOA cartilage degeneration.The coordination of knee flexor extensor muscles maintains the mechanical balance of knee joint,hamstring-based intervention is also important to improve the mechanical balance of KOA.This research is based on a National Natural Science Fundation"To investigate the mechanism of acupotomy therapy in regulating chondrocyte autophagy by mechanical effects in knee osteoarthritis based on phosphorylation of FAK-PI3K-AKT signal pathway ",acupotomy therapy was used as intervention in the hamstrings,attempting to observe the effect of acupotomy on bone marrow edema and hemorheology in KOA,further excavate the scientific connotation of Tendon Regulation and Bone Treatment.ObjectiveIn this study,under the guidance of muscle-sinew theory and combine with the understanding of acupotomy therapy for KOA,we observed the effects of acupotomy therapy on knee’s bone marrow edema and hemorheology in the tibial medullary cavity in KOA model rabbits,to investigate whether acupotomy therapy can cause benign changes in bone marrow edema and hemorheology of KOA by interventing in the hamstrings,and provide certain experimental and theoratical basis for the clinical application of acupotomy therapy in the treatment of KOA.MethodsIn this experiment,28 male New Zealand rabbits in healthy and clean of aged 6 months were randomly divided into 4 groups(n=7 in each group):normal group(NP),model group(MP),acupotomy group(AP)and electro-acupuncture group(EA).The KOA model was prepared by modified Videman’s left hindlimb extension fixation method for 8 weeks.One week after the end of modeling,the AP and EA group were intervented respectively.In the AP group,the stopping point of semitendinosus muscle tendon,semimembranous muscle tendon,biceps femoris tendon,nodule were loosed by acupotomy,once per week,for 3 weeks.In the EA group,electro-acupuncture on the left side of "Qu quan-Wei yang"and"Nei Xiyan-Wai Xiyan",using rarefaction-dense and continuous wave of 2/100Hz,3 mA,20min each time,3 times/week,for 3 weeks.The left hindlimb of each group was scanned by MRI with 3.0T MRI scanner,and the bone marrow edema was calculated by Whole Organ Magnetic Resonance Imaging Score(WORMS).The plasma viscosity and plasma fibrinogen content in each group were measured with automatic hemorheology tester and hemagglutination detector.With these methods,the different effect of AP and EA were compared.Results1.THE WORMS score results:compared to the NP,the WORMS score in the MP increased,with a significant difference(P<0.01).Compared to the MP,the scores of WORMS in the AP,EA both decreased,with a significant difference(P<0.01).There was no statistically significant difference in WORMS score between AP and EA(P>0.05),however,compared to the EA,the WORMS score of the AP had shown a clearer trend of decreasing.2.The plasma viscosity test results:compared to the NP,the plasma viscosity value of the MP increased,with a significant difference(P<0.01).Compared to the MP,the plasma viscosity values of AP,EA both decreased,and the difference was statistically significant(P<0.05).There was no statistically significant difference in plasma viscosity values between AP and EA(P>0.05).3.The plasma fibrinogen content detection results:compared to the NP,the plasma fibrinogen value of the MP increased,with a significant difference(P<0.01).Compared to the MP,the plasma fibrinogen values of AP,EA both decreased,and the difference was statistically significant(P<0.05).There was no statistically significant difference in plasma fibrinogen values between AP and EA(P>0.05).Conclusion1.Both acupotomy and electro-acupuncture can reduce the degree of bone marrow edema in KOA model rabbits,and the decreasing trend of bone marrow edema after acupotomy therapy intervention is more obvious than that of electroacupuncture.2.Both acupotomy and electro-acupuncture can reduce the elevated plasma viscosity and plasma fibrinogen content in the tibial medullary cavity of KOA model rabbits and improve the hemorheological status.Acupotomy therapy can reduce the high viscosity of blood in the tibial medullary cavity of KOA model rabbits.