Clinical Observation Of Ultrasound-guided Acupotomy Combined With Knee Drug Injection In The Treatment Of Knee Osteoarthritis

Objective:Knee osteoarthritis(KOA)has a high incidence in middle-aged and elderly patients,although there are various therapeutic methods,the overall effect is not satisfactory.In this study,the efficacy of ultrasound-guided acupotomy combined with knee drug injection in the treatment of KOA was observed.It aims to provide a safe and reliable treatment for clinical treatment of KOA.Methods: Eighty patients with knee osteoarthritis were selected as the research object in the outpatient department of rehabilitation of Linyi People’s Hospita,and they were randomly divided into the control group and the observation group,with 40 patients in each group.The control group received ultrasound-guided knee drug injection once a week for 5 consecutive treatments,with 1ml of compound betamethasone and 2.5ml of sodium hyaluronate combined in the first treatment and 2.5ml of sodium hyaluronate alone in the last four treatments.On the basis of the control group,the observation group was given ultrasound-guided small acupotomy during the first three treatments.Seven points including stopping point of quadriceps tendon,starting and stopping point of tibial collateral ligament,starting and stopping point of peroneal collateral ligament,patellar ligament attachment point,and goose foot tendon insertion point were selected as the operation points,and acupotomy operation was performed on the operation points under the guidance of ultrasound.VAS,WOMAC,knee flexion range of motion,and depth of hydrops in the suprapatellar capsule were selected as the observation indexes,and were recorded and analyzed before treatment,1week after treatment,and 8 weeks after treatment.Results:(1)A total of 80 patients who met the selection criteria were included in this study,of which 2 patients in the control group were lost to follow-up,and a total of 78 patients finally completed this study.(2)There was no significant difference in gender,age,course of disease,affected side,imaging grading,VAS score,WOMAC score,knee flexion range of motion and depth of hydrops in the suprapatellar capsule before treatment between the two groups(P > 0.05),indicating comparability.(3)1 week after treatment and 8 weeks after treatment,VAS,WOMAC,knee flexion range of motion and depth of hydrops in the suprapatellar capsule in 2 groups were significantly better than those before treatment(P < 0.05).(4)1 week after treatment,there was no significant difference in VAS between the two groups(t =-1.636,P = 0.106),WOMAC between the two groups(t =-0.789,P = 0.433),and there was no significant difference in depth of hydrops in the suprapatellar capsule between the two groups(t =-1.014,P = 0.314),there was a significant difference in knee flexion range of motion between the two groups,and it was greater in the observation group(t = 5.484,P = 0.000).(5)8 weeks after treatment,VAS was significantly lower in the observation group than that in the control group(t=-4.497,P=0.000),WOMAC was significantly lower in the observation group than that in the control group(t=-3.001,P=0.004),and the depth of hydrops in the suprapatellar capsule was significantly lower in the observation group than that in the control group(t=-3.133,P=0.002),knee flexion range of motion in the observation group was significantly greater than that in the control group(t=7.518,P=0.000).Conclusions: Ultrasound-guided acupotomy combined with knee drug injection in the treatment of knee osteoarthritis is safe and reliable,can relieve pain,reduce joint hydrops,increase the range of motion,improve joint function,compared with pure knee drug injection,it has better maintenance effect,worthy of clinical romotion.