Clinical and Animal Studies of Waist and Knee Scraping Therapy for
Knee Osteoarthritis
Authors: Jin Qianhong , Chen Mingrui , Kong Jing , Chen Dandan , Wu Xuan , Shi Xiaoqing , Jie Lishi , Yu Likai , Li Sha , Dai Zhengxiang 
Published: January 2024

Background:
Knee osteoarthritis (KOA) is a degenerative condition with knee pain as the main clinical
manifestation. Scraping is one of the commonly used traditional Chinese medicine treatment methods, which
activates blood circulation, removes blood stasis, reduces inflammation, and so on. Although scholars have proposed
that the synergistic treatment of the waist and knee for KOA is superior to simple knee treatment, there is
no relevant reference literature on the application of scraping therapy. Therefore, this study aims to explore the
effectiveness and potential mechanisms of waist and knee scraping therapy for treating KOA through clinical and
animal studies in order to promote its clinical application.

Objective:
To explore the clinical efficacy of waist and knee scraping therapy in the treatment of KOA from clinical
study and increase animal study on this basis to preliminarily explore its mechanism, providing an objective
basis for better treatment of KOA.

Methods:
The clinical study recruited 90 KOA patients and divided them into a control group, a knee scraping
group, and a waist and knee scraping group using a random number table method. All patients were evaluated for
clinical efficacy, the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC), and Traditional
Chinese Medicine Syndrome Score. The KOA rat model was established using the Hulth method. The rats were
randomly divided into a control group, KOA group, waist scraping group, knee scraping group, and waist and
knee scraping group. During the intervention process of rats, the pain sensitivity threshold was measured, and HE
staining was performed on the synovium and cartilage. The protein and mRNA expression levels of TNF-α, IL-
1β, IL-6, PGP9.5, SP and TRPA1, TRPV4, SP, and NGF were measured by Western blot and real-time PCR.

Results:
In the clinical study, the clinical efficacy of the 2 scraping groups was significantly higher than that of
the control group. The clinical efficacy of the waist and knee scraping group on the 60th day of treatment was
significantly higher than that of the knee scraping group. In terms of improving WOMAC scores, all 3 groups
had significance; The function and total score of the waist and knee scraping group on the 28th day of treatment,
as well as the pain, function, and total score on the 60th day, were lower than those of the knee scraping group. In
terms of improving pain while standing, pain when walking on flat ground, and total score, the scraping group
had significant differences. The score of heavy limbs in the waist and knee scraping group was lower than that in
the knee scraping group.

:
In an animal study, during the 4th week after modeling, there were differences in the pain sensitivity threshold
between the KOA group and the waist scraping group compared to the control group, while there were differences
in the pain sensitivity threshold between the knee scraping group and the waist and knee scraping group
compared to the KOA group. The expression levels of various proteins and genes in the KOA group and waist
scraping group increased compared to the control group; The knee scraping group and the waist and knee scraping
group were lower than those in the KOA group.

Conclusion:
Scraping therapy can significantly alleviate knee joint pain and stiffness, improve joint function, and
improve clinical efficacy, and the short-term and long-term effects of waist and knee scraping therapy are more significant.
The scraping therapy has a definite therapeutic effect on KOA rats, which can improve the threshold of cold
hyperalgesia and mechanical hyperalgesia, and the waist and knee scraping therapy is more obvious. This may be
related to reducing inflammatory reactions in synovial and ganglion tissues.