Sofastin injection needle-knife with the treatment of knee osteoarthritis clinical

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Knee osteoarthritis (Osteoarthritis, OA) is a chronic joint disease, mainly characterized by degeneration of articular cartilage and inflammatory bone hyperplasia. Common in the elderly, the disease mechanism is currently unknown, most scholars believe that with aging, inflammation and metabolism. With the accelerated aging of our population, the incidence rate increased subsequently, in the middle-aged Chinese are now up to 7.8%, seriously affecting the quality of life of older persons. Although the treatment of OA more, but the effects are not ideal, can not prevent or delay the occurrence of disease and development. To study Sofastin injection needle-knife with the clinical efficacy of OA, the author will be from March 2003 to March 2007 were treated 230 cases of OA were randomly divided into two groups, its effects were compared. Reported as follows.
A clinical data
1.1 General information on the observation group 120 cases, male 42 cases, female 78 cases; aged 43 to 86 years of age; course of disease 7 months to 6 years. Danxi 56 cases, 64 cases of both knees, a total of 184 knee. Kellgren X ray classification: Ⅰ grade 31 knees, Ⅱ grade 86 knees, Ⅲ grade 43 knees, Ⅳ grade 24 knees. Control group, 110 cases, male 35 cases, female 75 cases; aged 45 to 87 years of age; course of 8 months to 6 years. Danxi 43 cases, 62 cases of both knees, a total of 167 knees. Kellgren X ray classification: Ⅰ grade 25 knees, Ⅱ grade 83 knees, Ⅲ grade 39 knees, Ⅳ grade 20 knees. Patients had varying degrees of knee pain, manifested as morning stiffness, pain started moving, after the event reduced, then increased walking activity and rest can be characterized by partial remission. Assessed by VAS pain score of 56 cases of mild, moderate 93 cases, 81 cases of moderate and severe. By knee function score method evaluation, 60 patients with mild activities, barriers, obstacles to the activities of 120 cases of moderate and severe obstacles to the activities of 50 cases.
1.2 diagnostic criteria adopted in 1995 revised American Rheumatism Association diagnostic criteria for OA, ≥ 3 of which would be consistent with these conditions, X-ray confirmed OA performers. OA X-ray film changes according to Kellgren classification method.
1.3 Treatment (1) General treatment:
① acute phase: joint effusion clear who puncture fluid, elastic bandage fixed. General puncture 1 ~ 3 times, and gradually ambulation.
 ② traditional Chinese medicine fumigation: fumigation using self-prepared Chinese medicine, the application of Chinese medicine products Dalian bed fumigation fumigation treatment, 2 times / d, 4 weeks for a course of treatment.
③ Oral: Nuosong tablets 0.4,1 times / d, Kangguzhengsheng films, 4 / time, 3 times / d, 4 weeks for a course of treatment.
(1) needle-knife therapy: patient supine knees, knees pads, pillows, regular elections point after disinfection, the application needle-knife around the right knee patella, suprapatellar bursa, infrapatellar pouch, infrapatellar fat pad, cruciate ligament, intercondylar eminence and , the lateral collateral ligament and biceps femoris, semitendinosus, semimembranosus, iliotibial tract, etc. attached to the point of tenderness and bone hyperplasia Department degeneration, scarring, adhesions and contracture of the soft tissue release and shovels to cut grinding, leveling, etc. The treatment facilities within the surgery. Needle-knife treatment options depending on the specific point of knee localized disease may be more of a one election 8:00, less of a one 3:00, the election mostly 5 to 6 o'clock.

[2] needle-knife treatment of postoperative external means, ie prior to flat direction of the patellofemoral joint surface pushed by the upper and lower left patella, do not push to the rear, loosen patellofemoral adhesions, and then the passive knee flexion and extension, loosen tibial-femoral joint adhesion.
(3) intra-articular injection: The Sofastin (sodium hyaluronate injection) 2ml intra-articular injection, 1 times / week, were injected four times.
(4) treatment options: observation group were treated with the general treatment, needle-knife therapy combined with intra-articular injections of Sofastin the control group using the general treatment, both after treatment effects were evaluated after 3 months.
1.4 Efficacy in VAS pain score assessed pain intensity before and after treatment changes: O into painless, 1 ~ 3 were divided into mild, 4 to 6 is divided into moderate, 7 to 9 pm was severe, 10 were divided into severe pain. More down the stairs, squatting activities, assessment of knee joint function; O sub-normal, a sub-mild, 2 points moderate, 3 severe, 4 points loss of function.
1.5 Statistical analysis measurement data in order to (x ± s), said the use of statistical data analysis and processing SPSS10.0 statistical software.
2 Results
Treatment of a course of treatment in both groups, at the end of treatment within a specified time after the follow-up, according to the VAS pain score assessed before and after treatment efficacy, the results shown in Table 1,2, the two groups after treatment in patients with joint pain were alleviated knee joint function of the observation group improved significantly better than the control group. The two groups were not related complications occurred. Table 1 the two groups before and after treatment VAS pain score comparison table two groups before and after treatment of knee joint function score comparison (Note: △ before and after treatment P <0.01, ▲ after treatment the two groups P <0.01.
3 Discussion
 Knee osteoarthritis (OA) is due to degeneration of articular cartilage and joint synovitis characterized by the transformation of intra-articular lesions. Knee osteoarthritis is a cartilage degeneration, destruction, joint surface, the edge of reactive hyperplasia, osteophytes arising from the formation of secondary inflammatory synovium, joint capsule and soft tissue pathologic changes to joint pain and dysfunction of The main clinical manifestations. With the onset hiding, slow progress, while the prevalence rate increased with age characterized by the elderly of the common and frequently-occurring disease.
Clinically, with joint swelling, pain, stiffness, limited mobility, muscle atrophy, joint distortion characterized. Late medial joint space narrowing, often a result of extensive cartilage destruction flexion deformity. Synovial membrane and joint support structure surrounding proliferative changes were accompanied by chronic damage to the tissues around joints, in tissue repair occurs when the ligaments, muscle and bone between the adhesion.
The formation of local scarring, adhesions, muscle disuse atrophy. There authors found that there is arthritis, the muscles around the trigger point (TrP), the point EMG testing (EMG) activity, especially the inner thigh muscle tension Office. TrP through treatment can effectively eliminate EMG changes.
Needle-knife therapy can be used directly on the patella and the joint space to conduct cutting-week, sneak lysis patellar weeks tendons, ligaments, bursa and other soft tissue scar adhesions, contracture, destruction TrP, improve blood circulation, and soft tissue adhesion, the elimination of nerve endings to stimulate to improve blood circulation and the lifting of reflex muscle spasm, soft tissue to restore knee movement coordination, effectively regulate the balance between structural mechanics around the knee to enhance knee stability, while the needle through the needle-knife effect, and clear the meridians, to reconcile qi and blood, to "General does not hurt," the purpose [2]. YU Jie et al [3] that the needle-knife therapy can gradually restore joint kinetics of dynamic balance, mitigate and alleviate the friction knee injury, relieve pain, swelling, promote the function of the knee to recover. Combination of intra-articular injection of polymers, high-viscosity elastic Sofastin (glass sodium injection), can effectively improve the unit - tibial and femoral - patellar articular and synovial tissues between the coefficient of friction joints to reduce wear and eliminate inflammation.

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