To observe the effect of acupotomy on cartilage degeneration in rabbits with knee osteoarthritis (KOA) from the perspectives of force line and knee joint stress distribution, and to explore the biomechanical mechanism of acupotomy for KOA. A total of 24 male New Zealand rabbits were randomly divided into a normal group, a model group, an electroacupuncture (EA) group and an acupotomy group, 6 rabbits in each group. Except for the normal group, in the other 3 groups, the left hind limbs were immobilized for 6 weeks to establish KOA model using the modified Videman method. In the EA group, EA was applied at left "Neixiyan" (EX-LE4), "Dubi" (ST35), "Zusanli" (ST36) and "Yanglingquan" (GB34), with disperse-dense wave, in frequency of 2 Hz/100 Hz and current of 3 mA, 20 min each time, once every other day. In the acupotomy group, acupotomy intervention was delivered at the insertion site of the vastus medialis tendon, insertion site of the vastus lateralis tendon, etc. of the left knee joint, once a week. The interventions lasted for 3 weeks in the EA group and the acupotomy group. Before and after intervention, the Lequesne MG score was observed. After intervention, the force line angle of knee joint was measured by magnetic resonance imaging (MRI); the stress distribution of the knee joint was observed by the three-dimensional finite element analysis; the morphology of knee joint cartilage was observed by HE staining; the protein expression of type Ⅱ collagen (Col-Ⅱ) and Aggrecan in the knee joint cartilage was detected by Western blot. Compared with the normal group, the Lequesne MG score was increased (P<0.01), the knee joint force line angle was increased (P<0.05), and the protein expression of Col-Ⅱ and Aggrecan in the knee joint cartilage was decreased (P<0.01) in the model group. Compared with the model group, the Lequesne MG scores were decreased (P<0.05, P<0.01), the knee joint force line angles were decreased (P<0.05), and the protein expression of Col-Ⅱ and Aggrecan in the knee joint cartilage was increased (P<0.05) in the EA group and the acupotomy group. All the above indexes in the acupotomy group were superior to those in the EA group (P<0.05). Severe cartilage damage, disordered arrangement of chondrocytes and unclear tide line could be observed in the model group. Compared with the model group, the damage of knee joint cartilage was alleviated, the arrangement of chondrocytes was more orderly and the tide line was clearer in the EA group and the acupotomy group, and the improvement of knee joint cartilage damage in the acupotomy group was superior to that in the EA group. Compared with the normal group, in the model group, the peak Von Mises stress and peak contact stress, the stress value and the contact stress value in the high-stress areas of the knee joint were increased (P<0.05), the stress was more concentrated. Compared with the model group, in the EA group and the acupotomy group, the above stress-related indexes were decreased (P<0.05), the stress concentration was relieved, and those in the acupotomy group were superior to the EA group (P<0.05). Compared with the normal group, in the model group, the ratios and the contact areas of the medial and lateral condyles of the meniscus, femoral cartilage and tibial cartilage were significantly deviated. Those in the EA group and the acupotomy group tended to be more similar to the normal group, and those in the acupotomy group were superior to the EA group. Acupotomy can correct the knee joint force line, improve the stress concentration, delay cartilage degeneration of the knee joint, thereby improving the symptoms of KOA. 目的：从力线、膝关节应力分布角度观察针刀对膝关节骨关节炎（KOA）兔软骨退化的影响，探讨针刀干预KOA的生物力学机制。 方法：将24只雄性新西兰兔随机分为正常组、模型组、电针组、针刀组，每组6只。除正常组外，其余3组兔左后肢采用改良Videman法制动6周以建立KOA模型。电针组予电针左侧“内膝眼”“犊鼻”“足三里”“阳陵泉”，疏密波，频率2 Hz/100 Hz，电流3 mA，每次20 min，隔日1次；针刀组于左侧膝关节股内侧肌肌腱止点、股外侧肌肌腱止点等处行针刀干预，每周1次，均干预3周。干预前后，观察各组兔奎森功能障碍指数（Lequesne MG）评分。干预后，采用磁共振成像（MRI）观察各组兔膝关节力线角度；采用三维有限元分析法观察各组兔膝关节应力分布情况；采用HE染色法观察各组兔膝关节软骨形态学；采用Western blot法检测各组兔膝关节软骨Ⅱ型胶原蛋白（Col-Ⅱ）和聚集蛋白聚糖（Aggrecan）蛋白表达。 结果：与正常组比较，模型组Lequesne MG评分升高（P<0.01），膝关节力线角度增大（P<0.05），膝关节软骨Col-Ⅱ、Aggrecan蛋白表达降低（P<0.01）；与模型组比较，电针组与针刀组Lequesne MG评分降低（P<0.05，P<0.01），膝关节力线角度减小（P<0.05），膝关节软骨Col-Ⅱ、Aggrecan蛋白表达增高（P<0.05）；针刀组上述指标均优于电针组（P<0.05）。模型组膝关节软骨损伤严重，软骨细胞排列紊乱，潮线不清晰；与模型组比较，针刀组、电针组膝关节软骨表面损伤均减轻，软骨细胞排列更为有序，潮线更为清晰，针刀组膝关节软骨损伤改善程度优于电针组。与正常组比较，模型组Von Mises应力峰值、接触应力峰值及高应力区域应力值、高应力区域接触应力值升高（P<0.05），应力分布更集中。与模型组比较，针刀组与电针组上述各项应力指标均降低（P<0.05），应力集中程度减轻，且针刀组优于电针组（P<0.05）。与正常组比较，模型组半月板、股骨软骨、胫骨软骨内外侧髁比值及内外侧接触面积均显著偏离；针刀组与电针组半月板、股骨软骨、胫骨软骨内外侧髁比值和内外侧接触面积均接近正常水平，且针刀组优于电针组。 结论：针刀干预可纠正膝关节力线，改善膝关节应力集中现象，延缓软骨退化，从而改善KOA症状。.
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PubMed · 2026-05-12
PubMed · 2026-04-12
PubMed · 2026-05-12