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[Biomechanical mechanism of acupotomy on cartilage degeneration in KOA rabbits based on three-dimensional finite element model].

Zhongguo zhen jiu = Chinese acupuncture & moxibustion·May 2026·Zili Tan, Hainan Gao, Xinxin Shao et al.
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Key Finding

Acupotomy significantly corrected knee joint force line angles and reduced stress concentration better than electroacupuncture, while increasing protective cartilage proteins and improving joint biomechanics in osteoarthritic knees.

What This Means For You

Researchers in China studied whether acupotomy—a technique combining acupuncture with surgical needle release—could help knee osteoarthritis by improving joint mechanics. They divided 24 rabbits into four groups: normal, untreated osteoarthritis, electroacupuncture treatment, and acupotomy treatment. The animals with knee osteoarthritis had their legs immobilized for six weeks to create the condition, then received three weeks of treatment. The electroacupuncture group received stimulation at four acupuncture points every other day, while the acupotomy group received needle-knife treatment at tendon attachment sites once weekly. The study used advanced imaging and computer modeling to measure how forces traveled through the knee joint and where stress concentrated. Results showed that acupotomy significantly improved knee function scores and corrected abnormal force distribution through the joint better than electroacupuncture alone. Acupotomy also increased protective proteins in cartilage (type II collagen and aggrecan), reduced damaging stress concentrations, and helped restore normal contact patterns between joint surfaces. Under microscope examination, cartilage showed less damage and better organization after acupotomy treatment. The researchers concluded that acupotomy works by correcting the mechanical alignment of the knee joint, redistributing stress more evenly, and slowing cartilage breakdown. While this animal study shows promising biomechanical effects, human clinical trials are needed to confirm these benefits for people with knee osteoarthritis. If considering acupotomy or acupuncture for knee pain, seek a qualified, licensed practitioner trained in these specialized techniques.

Clinical Notes for Practitioners

This rabbit model study (n=24) examined acupotomy's biomechanical effects on knee osteoarthritis using three-dimensional finite element analysis. Following six-week immobilization-induced KOA, subjects received either electroacupuncture (EX-LE4, ST35, ST36, GB34; 2/100Hz; 20min every other day) or acupotomy at vastus medialis/lateralis tendon insertions (weekly) for three weeks. Acupotomy demonstrated superior outcomes versus electroacupuncture across multiple parameters: significantly reduced Lequesne MG scores (P<0.01), decreased knee joint force line angles (P<0.05), and increased cartilage Col-II and Aggrecan expression (P<0.05). Finite element modeling revealed acupotomy significantly reduced Von Mises stress peaks, contact stress values, and stress concentration in high-load areas (P<0.05), while normalizing medial-lateral condyle load distribution ratios. Histologically, acupotomy groups showed improved chondrocyte organization and tidemark clarity versus controls. Clinical implications suggest acupotomy may address KOA pathology through biomechanical realignment and stress redistribution, potentially offering advantages over standard electroacupuncture for mechanically-mediated cartilage degeneration.

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