Treatment of knee osteoarthritis by acupuncture combined with Tuina massage for both the knee and ankle joints simultaneously

Objective: To state the efficacy and safety of acupuncture combined with Tuina massage for both the knee and ankle joints simultaneously in treating knee osteoarthritis (KOA). Methods: A total of 70 KOA patients visiting the Orthopedic Clinic, Hebei University of Chinese Medicine from September 2021 to September 2022 were enrolled and randomly divided into the treatment group and control group, with 35 cases per group. After excluding 2 cases of self-withdrawal in the control group, and 3 drop-out cases in the treatment group (2 with poor compliance, and 1 with personal affair), 33 in the former and 32 in the latter were finally included for the analysis. KOA patients in the treatment group were treated with acupuncture combined with Tuina massage for both the knee and ankle joints simultaneously, while those in the control group were similarly managed but only targeting on the knee only. Interventions were given once every other day, for 12 sessions. The Visual Analogue Scale (VAS) score, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), active range of motion (AROM) of the knee, and serum IL-1β, TNF-α and MMP-3 before and after treatment were compared between groups. Results: The effective rate was significantly higher in the treatment group than the control group (90.63% vs. 69.70%, P <0.05). Post-treatment VAS score, WOMAC, and serum IL-1β, TNF-α and MMP-3 were significantly reduced, while AROM of the knee was significantly increased in both groups ( P <0.05), which were significantly pronounced in the treatment group than the control group ( P <0.05). Conclusion: Acupuncture combined with Tuina massage for both the knee and ankle joints simultaneously is superior to the target of knee solely. It effectively masks pain, improves knee function, and increases AROM of the knee in KOA patients by lowering serum IL-1β, TNF-α and MMP-3.