Abstract:

Objective

To investigate the effect of shock wave （ESW） intervention on serum tumor necrosis factor-α （TNF-α） and interleukin-1β （IL-1β） in patients with knee osteoarthritis （KOA） after arthroscopic treatment and their relationship with knee joint function.

Methods

A prospective study was conducted according to the inclusion criteria ： Kellgren-Lawrence grade I and II ； unilateral onset ； knee pain recurred in the past one month. Exclusion criteria ： osteoporosis ； arthroscopic contraindications ； severe knee varus and valgus deformity. A total of 110 patients with KOA admitted to Department of Rehabilitation Medicine，Chengdu Second People’s Hospital from June 2022 to June 2023 were selected as the research objects. They were divided into two groups according to the random number table method， 55 cases in each group. The control group was treated with arthroscopy combined with routine intervention， and the observation group was treated with ESW intervention on the basis of the cont rol group for five weeks. The patients were followed up for 24 weeks after intervention. The recovery of knee joint at different time points ［visual analogue scale （VAS）， knee joint function score （Lysholm）， knee joint range of motion （ROM）］was compared between the two groups. The levels of inflammation （TNF-α， IL -1β） were measured before and 24 weeks after intervention. The relationship between serum TNF-α， IL -1β levels and knee joint recovery in patients with KOA was analyzed by bivariate correlation Pearson.

Results

At 12 weeks and 24 weeks of treatment， the VAS scores of the two groups were lower than those before the intervention and showed a downward trend. The observation group was lower than the control group. The Lysholm score and ROM were higher than those before the intervention and showed an upward trend. The observation group was higher than the control group. The time points， groups and crosscomparisons between the two groups （VAS F=5.711， 932.505， 3.672； Lysholm score F=64.898， 664.241，20.591； ROM F=400.230， 1026.558， 77.387； all P＜0.05）. After intervention， TNF-α， IL-1β in the two groups were lower than those before intervention， and those in the observation group were lower than those in the control group （t=11.212，5.065， both P＜0.05）. The results of bivariate correlation Pearson analysis showed that the serum levels of TNF-α and IL-1β in patients with KOA were positively correlated with VAS level（r =0.356， 0.205， both P＜0.05）， and negatively correlated with Lysholm score and ROM （TNF-α r=-0.429，-0.574； IL-1β r=-0.339， -0.369； both P＜0.05）.

Conclusions

Arthroscopic intervention combined with ESW intervention in KOA patients can effectively relieve knee joint pain， improve knee joint range of motion，improve knee joint function， and reduce the body’s inflammatory response. Serum TNF-α and IL-1β levels are related to knee joint function.

Key words: Osteoarthritis， knee, Arthroscopes, Extracorporeal shockwave therapy, Tumor necrosis factor-alpha, Interleukin-1beta