Please select the eligibility criteria that correspond to the clinical trial below.
Title: The Experiences for Receiving Auriculotherapy for Osteoarthritis Knee: A Randomised Controlled Feasibility Study.
Brief Summary: Osteoarthritis (OA) is the most common form of arthritis in Hong Kong and a prevalent condition in the ageing population. With disease progression, some clients may develop severe pain and profound limitations in ambulation, which may result in morbidity and impaired physical functions. Among the available treatments, pharmacological therapies primarily focus on musculoskeletal pain relief. However, adverse effects, such as gastrointestinal haemorrhage arising from non-steroidal anti-inflammatory drugs have led to an increasing number of concerns regarding the use of these treatments. Other non-invasive complementary methods for osteoarthritic knee (OA knee) should be explored because of the limitations of pharmacological therapy.

Auriculotherapy (AT) is one of the approaches in traditional Chinese medicine (TCM). It is a therapeutic method by which specific points on the auricle are stimulated to treat various disorders of the body. The present study is a four-arm randomised controlled study to determine the effectiveness of AT using magneto-AT (MAT) and/or laser AT (LAT) to improve the conditions of elderly patients suffering from OA knee. The effectiveness of MAT and LAT in terms of alleviating pain, relieving stiffness and promoting a range of motion, and enhancing functional abilities will be determined.

Subjects in 'Treatment arm 1' will receive MAT on specific auricular points on one side of the ear during each treatment session. A deactivated laser will be used to achieve the effect of subject blinding. Subjects in 'Treatment arm 2' will receive LAT using low-energy laser applied to selected acupoints of the ear, and a plaster centred with a portion of Junci Medulla that mimics MAT treatment will also be given. Subjects in 'Treatment arm 3' will receive a combined approach (both MAT and LAT). Subjects in the 'placebo arm' will serve as placebo controls. Six auricular acupoints that are considered to have an effect on the OA knee will be selected. Only one ear at a time will receive treatment. Thus, the ears will be treated alternately. The total treatment period will be four weeks. The experimental objects will be replaced every other day. Therefore, treatment will be performed thrice a week. Subjects will be assessed at baseline up to 3 months after the therapy. This study could advance the knowledge on the complementary approaches than can be used to improve OA knee conditions in the elderly.


Options:
A: Inclusion Criteria:

* Participants aged 62 years and older.
* Unilateral or bilateral disfunction and/or knee pain.
* Primary knee ostearthritis fulfilling the American College of Rheumatology criteria for clinical and radiographic diagnostic.
* At least 1 pain point elicited by palpation ipsilateral to the painful knee situated in a taut band of a skeletal muscle of the lower limbs, which usually have referred pain.

Exclusion Criteria:

* Prior diagnoses or prescriptions in the medical record for myopathy or lumbo-sacral neuropathy.
* Previous knee or hip joint replacement surgery of the affected joint.
* Any other surgical procedure of the lower limbs in the previous 6 months.
* Rheumatoid arthritis.
* Initiation of opioid analgesia or cortico-steroid or analgesic injection intervention for hip or knee pain within the previous 30 days.
* Alcohol or drugs consumption.
* Uncontrolled hypertension or moderate to high risk for cardiac complications during exercise.
* Conservative or invasive physical therapy (previous 6 months or during follow-up).
* Taking antiaggregant or anticoagulant medications.
* Physical impairments unrelated to the hip or knee preventing safe participation in exercise, walking or stationary cycling, such as: vision problems that affect mobility, body weight greater than 155 kg, neurogenic disorder, primary or significantly limiting back pain, advanced osteoporosis, or inability to walk 10 metres without an assistive device.
* Inability to comprehend and complete study assessments or comply with study instructions.
* Stated inability to attend or complete the proposed course of intervention and follow-up schedule.
* Fibromyalgia syndrome or other altered affective/cognitive modulation processes of pain perception. .
B: Inclusion Criteria:

The OA condition will be assessed by physical examination based on the clinical criteria of the American College of Rheumatology criteria. The clinical criteria consisted of pain in the knee and any three of the following:

1. aged 50 years of age or over;
2. \<=30 minutes of morning stiffness;
3. crepitus on active joint motion;
4. bony tenderness;
5. bony enlargement; or
6. no palpable joint warmth.

This classification has been reported to yield 84% specificity and 89% sensitivity for diagnosis of OA knee.

Exclusion Criteria:

1. other connective tissue diseases affecting the knee;
2. knee joint steroid injections within the preceding three months;
3. having a hearing aid or pacemaker in situ (this is to avoid possible interaction between the pacemaker and the magnetic pellets);
4. receiving AT within the preceding three months;
5. suffering from aural injuries or infections; and
6. inability to understand instructions or give consent.

The assessment is conducted by a research assistant who will receive intensive coaching on the physical assessment and therapy administration by the research team. Potential subjects will be further assessed by a registered medical practitioner who has over 15 years of clinical experience when the assessment on the OA condition by the RA and the research team is in doubt.
C: Inclusion Criteria:

* patients referred from general practitioner, chiropractor or orthopaedic surgeon
* unilateral hip pain of minimum 3 months' duration
* radiology criteria for hip OA: joint space width (JSW) \< 2.0 mm or a side difference in JSW of \> 10%
* adequate mastering of the Danish language to complete instructions and questionnaires

Exclusion Criteria:

* inflammatory joint disease
* previous hip or knee alloplastic
* secondary arthritis due to hip fracture or infection
* bilateral hip pain
* hip dysplasia with a CE angle \> 25 degrees and an AA angle \> 10 degrees
* low back pain which dominates over the hip pain
* malignant disease
* patients with paresis or paralysis after neuromuscular, cerebrovascular or polyneuropathic disease
* hip pain resulting from labral tear, bursitis and/or snapping hip syndrome
* polyarthritis
* received manual treatment for the hip within the last year
D: Inclusion Criteria:

* Medial knee osteoarthritis
* Pain
* No foot problems
* Lives in Boston, Massachusetts Metro area

Answer: B