Could Metabolic Risk Factors Affect the Severity of Knee Osteoarthritis in Type-2 Diabetes Mellitus Patients? A Cross-Sectional Study

Introduction: Osteoarthritis (OA) is a common joint disease with varying degrees of severity. Patients with type-2 diabetes mellitus (T2DM) demonstrate a higher prevalence of OA, and several mechanisms have been proposed to explain the severity of OA in DM. In this study, we aimed to explore the effect of metabolic risk factors on the severity of knee OA in T2DM patients. Methods: This cross-sectional study was conducted in 2018 and included 57 patients with T2DM. Data were collected in terms of demographic variables and metabolic tests. After obtaining a medical history and examination, anteroposterior (AP) and lateral radiographs of both knees were taken, and the severity of OA was classified using the Kellgren-Lawrence (KL) classification system and categorized into two groups. Group A demonstrated patients with mild OA equivalent to grade 1 or 2 KL and group B showed moderate to severe OA (grade 3 or 4 KL). Results: A total of 57 patients with T2DM enrolled in the study, of which 32 patients exhibited grade 1 or 2 KL (group A) and 25 with grade 3 or 4 KL (group B). The mean age and mean body mass index (BMI) were higher in group B compared to group A, and the differences were statistically significant (P-value = 0.01). As with the other metabolic tests, the mean serum hemoglobin A1C (HbA1c) level was not statistically significant (P-value = 0.34). Conclusion: The data revealed that metabolic factors play a minor role in the severity of OA in patients with DM and that these changes are primarily influenced by increasing BMI and age.

Modified green dragon swaying its tail needling manipulation for treatment of knee osteoarthritis

Objective To compare the difference in the effect of modified green dragon swaying its tail needling manipulation and common needling manipulations on the overall rating of pain of patients with knee osteoarthritis, and to evaluate the advantages of modified green dragon swaying its tail needling manipulation for. Methods Ninety-five patients with knee osteoarthritis were divided into 2 groups according to the random number table method with 48 patients in the modified green dragon swaying its tail group（group special manipulation, SM group for short） and 47 patients in the common acupuncture group（group convention needling, CN group for short）, and different acupuncture manipulations were applied in the two groups. Internationally recognized Simplified Mc Gill Pain Questionnaire（SF-MPQ） scale used for description and measurement of pain was applied to evaluate the pain degree, including pain rating index（PRI）, visnal analogue scale（VAS）and present pain intensity（PPI）. The index of severity for osteoarthritis（ISOA） was adopted for evaluation of clinical efficacy. Results（1） In SM group, the scores of PRI, VAS and PPI were 6.63±4.67, 2.23±1.45 and 0.65±1.32, respectively, after treatment, and in CN group, the scores of PRI, VAS and PPI were 13.32±7.96, 4.34±1.79 and 2.28±1.21, respectively, the scores decreased in the two groups after treatment（all P〈0.05）, and the improvement in SM group was superior to that in CN group（all P〈0.01）.（2） The clinical cure rate in SM group was 52.08%, and the total effective rate was 97.92%, the clinical cure rate in CN group was 25.53%, and the total effective rate was 85.10%. The comparison of clinical cure rate in the two groups showed that P〈0.01. Conclusion The SM group is obviously superior to CN group in the improvement of overall rating of pain of patients. It is indicated that modified green dragon swaying its tail acupuncture therapy can effectively relieve the pain of patients with knee osteoarthritis, which was worthy of popularization and application with definite clinical efficacy