Acupuncture
with Gold Thread
for
Osteoarthritis of the Knee
Han-Gyul Yoo,
B.S., and Wan-Hee Yoo, M.D.
New England Journal of Medicine 2013; 369:e37December 26, 2013
A 65-year-old woman presented with pain in both knees. She had
received a diagnosis of osteoarthritis of the knee previously and had been
treated with analgesic agents and nonsteroidal antiinflammatory drugs. In
addition, she was treated intermittently with intraarticular injection of a
glucocorticoid. In spite of these therapies, the arthralgia in the knees did
not abate. Gastrointestinal discomfort caused by the medications necessitated
their discontinuation. Therefore, she underwent acupuncture with gold threads
as an adjunctive therapy once per week and more frequently when severe pain was
present. Radiography of the left knee revealed moderate subchondral sclerosis
of the medial portion of the tibia, osteophytosis of the medial portions of the
tibia and femur with possible narrowing of the joint space, and numerous
radiodense threads around the left knee joint (Panel A shows the
anteroposterior view, and Panel B the lateral view). Complementary medicine and
alternative medicine are often pursued in the treatment of osteoarthritis.
Acupuncture is widely used as a treatment for painful joints. It has been
hypothesized that gold thread implanted at the acupuncture points acts as a
continuous acupuncture stimulation. The insertion of small pieces of sterile gold
thread around the joint by means of acupuncture needles has been used commonly
in the treatment of osteoarthritis and rheumatoid arthritis in Asian countries.
Gold threads may complicate radiographic assessment, as seen here.
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