Interventions

A standard for verum acupuncture was defined to treat gonarthrosis. This treatment is based

on recommendations for an optimised acupuncture treatment in clinical studies [4] and based

on the most distinguished German textbooks [5-10], as well as from International Studies [11-

14]. Furthermore, the therapy was discussed with experts in the field of acupuncture.

The most important and most cited local points in literature were chosen as obligatory points.

Therefore the following local points has to be used for every treatment on the affected knee:

ST 34, ST 36, Xiyan (Extra 32, including2 needles), SP 9, SP 10 and GB 34. Points of this

combination can be omitted only in exceptional cases with documentation, e.g. needling was

not tolerated, inflammation or skin injury covering the acupuncture point. In every treatment,

the knee and adjoining musculature are examined for further, pressure-sensitive points (Ahshi

Points). In addition to the obligatory points, one to four of these Ahshi points per knee may

also be treated with acupuncture. These Ahshi points may be equivalent to the following local

acupoints: LR 7, LR 8, KI 10, BL 40, GB 33.

A selection of the most important distant points to treat pain in the knee is provided, of which

up to two distant points (maximum of four needles) can be chosen for an appropriate therapy

in accordance to the individual Chinese syndrome-based diagnosis and the localisation of the

cardinal symptom. The use of distant points is not essential. Only the following distant points

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may be used: LI 4, LI 10, LR 3, ST 44, ST 40, BL 23, BL 60, SP 5, SP 6, KI 3, KI 7, LI 15, SI

10, SI 8, TE 14, LU 6. The choice of distant points should be selected prior to the first acupuncture

session. This selection can be changed before starting a new acupuncture session if

needed.

Therefore the minimum number of needles is 7 and the maximum is 15. Treatment is performed

with sterilised disposable steel needles, 30 x 0.3 mm. The depth of needling should be

about 0.5 – 3.5 cm according to the localisation of points [9]. After needle insertion a DEQI

has to be tried to trigger in the verum group, followed by a manual stimulation of the needle,

which has to be repeated twice. If both knees are affected, both has to be treated with acupuncture

as indicated.

(aus: "http://www.biomedcentral.com/1472-6882/4/6" )