With the aging of the population, the incidence of osteoarthritis of the knee combined with osteoporosis is increasing year by year in China, and it is one of the main causes of joint pain and loss of working ability in middle-aged and elderly patients. There is a practical need and demand to actively investigate the prevention and treatment of osteoarthritis of the knee combined with osteoporosis. Modern medicine has not yet developed a holistic and unified treatment principle for this disease. Chinese medicine is experienced in treating this disease with obvious advantages and various modalities, including Chinese internal medicine, Chinese external medicine, Chinese physical therapy, Gong practice, and integrative therapy, which are hereby reviewed.

Yang Liu, Bingqian Wang, Wenxiang Hu, Yingang Li. Osteoarthritis of the Knee and Osteoporosis Therapy Advances in Chinese Medicine. Frontiers in Medical Science Research (2023) Vol. 5, Issue 6: 106-113. https://doi.org/10.25236/FMSR.2023.050617.

[1] Chen X, Liu JJ, Dong WT, Zhang BG, Li N, Xi FQ, et al. Research progress on the regulatory mechanism of osteoart hritis of the knee combined with osteoporosis [J]. Chinese Journal of Osteoporosis,2022,28(04):607-12+24.

[2] Kaiqiang S, Jian Z, Yi D, Ximing X, Fanqi K, Xiaofei S, et al. Gamabufotalin Inhibits Osteoclastgenesis and Counteracts Estrogen-Deficient Bone Loss in Mice by Suppressing RANKL- Induced NF-κB and ERK/MAPK Pathways [J]. Frontiers in Pharmacology,2021,12.

[3] Xin W, Xuefei W, Ran P, Chunlei X, Wei S, Huafeng Z, et al. Mapping knowledge landscapes and emerging trends of the links between osteoarthritis and osteoporosis: A bibliometric analysis [J]. Frontiers in Public Health,2022.

[4] Gun-Il I, Oh-Jin K, Hee KC. The relationship between osteoarthritis of the knee and bone mineral density of proximal femur: a cross-sectional study from a Korean population in women [J]. Clinics in orthopedic surgery,2014,6(4).

[5] P GP, P vdBJ. Osteoporosis and osteoarthritis: shared mechanisms and epidemiology [J]. Current opinion in rheumatology,2016,28(2).

[6] A LE, Y MS, M FR, David R, Robert P, N BF, et al. The prevalence of osteoporosis in patients with severe hip and knee osteoarthritis awaiting joint arthroplasty [J]. Age and ageing,2010,39(2).

[7] Zhao ZH, Wang R, Guo Y, et al. Study on the prevalence of knee osteoarthritis and correlation with osteoporosis [J]. Chinese Journal of Orthopaedics,2019(14):870-5.

[8] Xiao J, Fan BF. Mechanical correction of knee osteoarthritis pain [J]. China Journal of Pain Medicine,2020,26(08):608-11.

[9] B SH. Mechanical loading, cartilage degradation, and arthritis [J]. Annals of the New York Academy of Sciences,2010,1211(1).

[10] Li XH, Xu LM, Li H, et al. Relationship between uneven sedimentation theory and tendon imbalance in knee osteoarthritis [J]. Chinese Journal of Traditional Chinese Medicine,2019,34(04): 1481-3.

[11] Tianhua D, Wei C, Fei Z, et al. Radiographic measures of settlement phenomenon in patients with medial compartment knee osteoarthritis [J]. Clinical rheumatology,2016,35(6).

[12] Adeelah CATN, Fong LS, Suhaila M. Ficus deltoidea Prevented Bone Loss in Preclinical Osteoporosis/ Osteoarthritis Model by Suppressing Inflammation [J]. Calcified tissue international,2018,103(4).

[13] Kong QF, Gou Y, Tian F, et al. Involvement of bone metabolism modulators in the treatment of osteoarthritis:roles, problems and prospects [J]. China Tissue Engineering Research,2018,22(24): 3907-13.

[14] j RS, Frank B, A YD, et al. Interplay between genetics and epigenetics in osteoarthritis [J]. Nature reviews. Rheumatology,2020,16(5).

[15] Deepa H, S FG. Epigenetics of inflammatory arthritis [J]. Current opinion in rheumatology, 2018,30(2).

[16] Zhang J, Kong LB. Advances in Chinese and Western medicine research on postmenopausal osteoporosis with osteoarthritis [J]. Journal of Liaoning University of Chinese Medicine,2019,21(03): 15-8. 

[17] Yu X. L. Comparative analysis of medication patterns of prescriptions for the treatment of osteoporosis and osteoarthritis in Chinese medicine [J]. Electronic Journal of Clinical Medicine Literature,2018,5(62):70+5.

[18] Zhang Bo, Zhang Kaiwei, Ma Wenjuan, et al. Intervention of NF-KBp65 protein expression in rabbit chondrocytes of osteoporosis and osteoarthritis model by tonifying kidney and activating blood soup [J]. China Tissue Engineering Research,2019,23(27):4375-80.

[19] Dai Liao, Fan Yanbo, Zhao Yaliang, et al. Effect of Qing’e Decoction on the Expression of MMP3 and OPN in Subchondral Bone of Osteoarthritis Model Rats [J]. Chinese Journal of Traditional Medical Traumatology & Orthopedics,2020,28(10):1-59.

[20] Bao MJ, Xu Y. Clinical study on the combination of Douwuxiaosheng Tang with western medicine in the treatment of osteoarthritis of the knee joint combined with osteoporosis [J]. New Chinese Medicine,2019,51(10):54-6. 

[21] Ma F, Ma JZ, Gong F, et al. Effects of Strong Bone Joint Capsules on Bone Density and Estrogen Receptor Expression in SD Rats with Osteoarthritis and Osteoporosis [J]. Chinese Clinical Research. 2017,30(03):391-4.

[22] Zhu Yao, Li Jianmin. Clinical observation of Bonesongbao granules in the treatment of osteoarthritis of the knee with osteoporosis [J]. Chinese Journal of Traditional Chinese Medicine,2019,34(06): 2477-9.

[23] Fu S J, Yang B W, Shu C K,et al. Recent efficacy of He Xie Shao Yang in the treatment of osteoarthritis of the knee combined with primary osteoporosis [J]. Neimenggu TCM,2012,31(24):1-2. 

[24] Xu H, Zhou ZN, Fang Shuchen, et al. Effect of acupuncture point patching on SOD, MDA and GSH levels of wind-cold and damp paralysis type knee osteoarthritis in Wu Di population [J]. Chinese Journal of External Medicine,2020,29(05):5-7.

[25] Ma JY, Shi ZY, Shi XL. The effect of acupoint application therapy on serum OPG, RANKL and hip BMD in postmenopausal patients with osteoporosis [J]. China Journal of Osteoporosis,2017,23(07): 921-5.

[26] Huang T. Exploring the clinical efficacy of sodium vitrate injection and oral administration of strong bone capsule with Chinese herbal fumigation on early to mid-stage knee osteoarthritis with osteoporosis [J]. Chinese Medicine Clinical Research,2018,10(10):115-6.

[27] Wang jihong. Clinical observation of Chinese medicine fumigation combined with sodium glacial acid joint cavity injection in the treatment of knee osteoarthritis [J]. China Acute Chinese Medicine,2017,26(09):1654-6.

[28] Liu xiaodong. Effect of Chinese medicine ion introduction on inflammatory factor levels and functional recovery in patients with knee osteoarthritis [J]. The Journal of Medical Theory and Practice,2021,34(17): 3019-20. 

[29] Zhuang S W, Liu W Z, Yin H B. Clinical observation on the treatment of primary osteoporosis with Chinese medicine acupuncture point ion introduction [J]. China Health Standards Management, 2018,9(20):104-6.

[30] Ou Deyang, Huang Chaorong, Ou Yuanping, et al. Clinical efficacy of Chinese medicine sealing package combined with glucosamine sulfate in the treatment of early to mid-stage knee osteoarthritis [J]. Inner Mongolia Chinese Medicine, 2021,40(08):45-7. 

[31] Liu H, Deng M, Tang JJ, et al. The efficacy of the combination of the Governor's vein rubbing method and Chinese medicine sealing package in the treatment of osteoporotic low back pain in the elderly [J]. Practical Chinese Medicine,2020,36(04):533-4.

[32] Li Langming, Sheng Yanyan. 12 cases of osteoarthritis of the knee joint due to osteoporosis treated with multiple acupuncture points [J]. Practical Chinese Medicine Journal,2017,33(04):412-3.

[33] Chen RL, Deng KF, Wei XC, et al. A meta-analysis of the effects of electrodes on pain improvement and joint function in patients with osteoarthritis of the knee [J]. China Tissue Engineering Research, 2020,24(21):3438-44.

[34] Li Y, Wang Qiaoyun, Huang W. Efficacy of warm acupuncture with Qi in treating patients with wind-cold damp paralysis type knee osteoarthritis and the effect on serum TNF-α and IL-1β levels [J]. Acupuncture Clinical Journal,2022,38(11):25-9. 

[35] Li S J, Liu P, Zhao L N, et al. Meta-analysis of moxibustion for osteoarthritis of the knee [J]. Hainan Medical College,2019,25(22):1723-30. 

[36] Song H B, Liu J X, Liu H P, et al. Molecular mechanism of action of wnt/β-catenin signaling pathway-based acupuncture therapy on knee osteoarthritis [J]. Acupuncture Clin,2022,38(10):35-40. 

[37] Zhang X, Ye Gaxi, Pang Yuqian, et al. Meta-analysis of a randomized controlled trial of tui na therapy for osteoarthritis of the knee joint [J]. Practical Chinese Internal Medicine,2023,37(02): 56-9+157-8. 

[38] Song Shilong, Xue Mingxin, Tao Qi, et al. A randomized controlled study on the treatment of early to mid-stage knee osteoarthritis with Chinese orthopedic massage [J]. Chinese Journal of Integrative Medicine,2023,43(03):281-6.

[39] Zeng ZQ, Zhao Chuanxi, Liu WG. Recent efficacy observation and muscle strength analysis of Chinese medicine acupoint injection for early to mid-stage knee osteoarthritis [J]. Modern Medicine Health,2018,34(20):3114-8.

[40] Li Y, Zhong Caixiu. Exercise training with physical therapy for osteoarthritis of the knee [J]. China Modern Physician,2012,50(05):47-9.

[41] Yu Yating, Deng Jialin, Jian Tingting, et al. A meta-analysis of the effect of different physical therapies on pain relief in osteoarthritis of the knee joint [J]. Chongqing Medicine, 2022,51(08):1384-91.

[42] Wang B, Yu NS. Expert consensus on stepwise treatment of osteoarthritis of the knee (2018 edition) [J]. Chinese Journal of Joint Surgery (electronic version),2019,13(01):124-30.

[43] Dong X, Li JW, Lu BC, et al. Clinical observation on the treatment of osteoarthritis of the knee by combining kidney tonics and Tongluo pill with Badaanjin [J]. Shanxi Chinese Medicine,2022,38(07): 24-5. 

[44] Li Changhui, Tang Lizhu, Lin Binqiang, et al. Effect of Isokinetic Training Combined with Wu Qin-xi on Muscle strength of knee osteoarthritis and Long-term Effect [J]. Clinical Journal of Traditional Chinese Medicine,2021,33(01):157-61.