ABSTRACT
OBJECTIVE@#To study mechanism of improvement of stress concentration on patellofemoral joint by stiletto needle releasing lateral patellar retinaculum guided by the theory of Jinshugu() and based on the finite element model of knee joint. and to elucidate the biomechanical mechanism of stiletto needle releasing changing patellar trajectory and reducing patellofemoral joint pressure.@*METHODS@#CT data of knee joint from a normal male (aged 29, heighted 171 cm, weighted 58 kg) was selected. Starting with construction of three-dimensional model of knee joint by using finite element software, the finite element model of knee joint with complete tendonand bone structures were established through several steps, such as geometric reconstruction, reverse engineering, meshing, material assignment and loading analysis. The loading condition was set as 500 N load on knee joint, and the average tensile stress of quadriceps femoris tendon was about 200 N. To simulate the release of lateral patellar retinaculum by stiletto needle at 30 and 90 position of knee flexion in finite element model separately, and to compare the improvement of stress concentration of patellofemoral joint by stiletto needle intervention under different knee flexion conditions.@*RESULTS@#The peak stress of patellofemoral joint and tibiofemoral joint decreased after stiletto needle releasing of patellofemoral lateral retinaculum compared with before intervention, which was(1) knee flexion at 30 degrees:patellar cartilage decreased by 0.498 MPa (decreased 9.06%), femoral trochlea decreased by 0.886 MPa(decreased 16.27%);(2) knee flexion at 90 degrees:patellar cartilage decreased by 0.558 MPa (decreased 8.6%), femoral trochlea decreasedby 0.607 MPa (decreased 9.94%).@*CONCLUSION@#Releasing lateral patellofemoral retinaculum with stiletto needle could effectively alleviate the stress concentration of patellofemoral joint and reduce local stress peak value, which it is helpful to improve patellar trajectory and make stress distribution more uniform.
Subject(s)
Adult , Humans , Male , Biomechanical Phenomena , Finite Element Analysis , Knee Joint , Patella , Patellofemoral Joint , Quadriceps Muscle , Range of Motion, ArticularABSTRACT
<p><b>OBJECTIVE</b>To explore stiletto needle and needle-knife for influence of double sufficient weight in treating knee osteoarthritis patients.</p><p><b>METHODS</b>One hundred and thirteen early and medium term knee osteoarthritis patients were randomly divided into three groups, including stiletto needle group(38 cases), needle-knife group (38 cases) and voltaren group (37 cases). In stiletto needle group, there were 13 males and 25 females with an average of(55.87±7.72) years old, treated by stiletto needle once a week, and 2 weeks were a course; there were 11 males and 27 females in needle-knife group with an average of(57.11±7.07) years old, treated by acupotome once a week, and 2 weeks were a course; there were 12 males and 25 females in voltaren group with an average age of(57.62±8.08) years old, treated by votalin emulsion smearing 3 to 5 cm on painful area of knee joint, three times a day for 2 weeks; 36 patients in normal group, including 11 males and 25 females with a mean age of (55.28±7.55) years old, treated with nothing. Gravitational four lattice used to measure bipedal back and forth load before and after treatment in further observe weight-bearing situation among three groups, d value, which was the distance from center of gravity to original point, was measured as a obvervational index, JOA score was used to evaluate clinical effect.</p><p><b>RESULTS</b>Five patients were fall out, including 2 patients in stiletto needle group, 2 patients in needle-knife group and 1 patient in voltaren group. Other 108 patients were followed-up from 28 to 35 d with an average of 30 d, and without untoward effect. There was significant difference in d value between treatment group and control group at 1 month after treatment(<0.05); there was significant difference in d value among treatment group at 1 month after treatment(>0.05), and d value was decreased before treatment than that of after treatment. There was no significant difference in JOA score among treatment group after treatment at 1 month(<0.05); while had significant difference between groups(>0.05) after treatment at 1 month.</p><p><b>CONCLUSIONS</b>Stiletto needle, needle-knife and voltaren for the treatment of knee osteoarthritis at early and middle stage, center of gravity is closer to original point, and weight-bearing is improved. It is a easy method of four lattice to measure change of weight-bearing in KOA patients after treatment.</p>
ABSTRACT
Objective To investigate the clinical efficacy of stiletto needle acupuncture plus conventional acupuncture in treating cervical vertigo. Method Sixty patients with cervical vertigo were randomly allocated to treatment and control groups. The treatment group of 30 patients received stiletto needle acupuncture plus conventional acupuncture and the control group, conventional acupuncture alone. An assessment was made using the modified Cervical Vertigo Symptom and Function Evaluation Scale in both groups before and after treatment. Result After two courses of treatment, the total efficacy rate was 93.3% in the treatment group and 73.3% in the control group; there was a statistically significant difference between the two groups (P<0.05). There was a statistically significant pre-/post-treatment difference in the symptom score in the two groups and post-treatment difference in the symptom score between the two groups (P<0.01). Conclusion Stiletto needle acupuncture plus conventional acupuncture has a definite therapeutic effect on cervical vertigo. Its therapeutic effect is superior to that of conventional acupuncture alone.