ABSTRACT
Background and aim: Hypoxia of the cartilage has been considered as a potential pathogenic factor in knee osteoarthritis (KOA). Studies have shown that impaired blood perfusion of joint leads to cartilage hypoxia. Electroacupuncture (EA) has proven effects on pain relief and improving microcirculation. This study aimed to explore the effect of EA on articular microcirculation and cartilage anoxic and the underlying mechanisms. Procedures: Videman's method was used for 6 weeks to establish the KOA model. EA intervention was performed in four points around the knee for 3 weeks after KOA modeling. The Lequesne MG score was used to assess ethology. We recorded the oxygen tension of synovial fluid and the synovial microcirculation in vivo. HE-staining was used to assess cartilage morphology, and immunohistochemistry (IHC), Western blotting, and RT-PCR were used to assess expression of the major glycolytic enzymes glucosetransporter1 (GLUT1), pyruvate kinase M2(PKM2), and lactate dehydrogenase A (LDHA). Enzyme-linked immunosorbent assay (Elisa) was used to detect lactate content. Results and conclusion: There was a significant decrease in Lequesne MG score and improvement in Mankin score after EA intervention (P < 0.01), a significant increase in synovial microcirculation (P < 0.05) and synovial fluid oxygen tension (P < 0.01), and there was significant decrease in the expression of GLUT1, PKM2 and LDHA (P < 0.01) and lactate (P < 0.05). This study suggested that EA ameliorate cartilage hypoxia and regulate glycolytic metabolism in chondrocytes in KOA model rabbits by improving articular microcirculation and oxygen tension.
ABSTRACT
Knee osteoarthritis (KOA) is one of the most frequently encountered diseases in the orthopedic department, which seriously reduces the quality of life of people with KOA. Among several pathogenic factors, the biomechanical imbalance of the knee joint is one of the main causes of KOA. Acupotomology believes that restoring the mechanical balance of the knee joint is the key to treating KOA. Clinical studies have shown that acupotomy can effectively reduce pain and improve knee mobility by reducing adhesion, contracture of soft tissues, and stress concentration points in muscles and tendons around the knee joint. In this protocol, we used the modified Videman method to establish a KOA model by immobilizing the left hindlimb in a straight position. We have outlined the method of operation and the precautions related to acupotomy in detail and evaluated the efficacy of acupotomy in conjunction with the theory of "Modulating Muscles and Tendons to Treat Bone Disorders" through the detection of the mechanical properties of quadriceps femoris and tendon, as well as cartilage mechanics and morphology. The results show that acupotomy has a protective effect on cartilage by adjusting the mechanical properties of the soft tissues around the knee joint, improving the cartilage stress environment, and delaying cartilage degeneration.