Warm needling moxibustion effectively improves knee osteoarthritis in rats and shows superior efficacy compared with mild moxibustion, and its therapeutic mechanism may be associated with the inhibition of chondrocyte senescence.
Key Findings
Results
The MIA-induced KOA model produced functional impairment, joint swelling, and increased pain sensitivity in rats compared with normal controls.
Forty-eight Wistar rats were randomly assigned to 4 groups (n=12): normal, model, mild moxibustion, and warm needling.
KOA was induced by intra-articular injection of monosodium iodoacetate (MIA) into the right knee.
Model group had a significantly higher Lequesne MG score (P<0.01), increased right knee joint horizontal diameter (P<0.01), and decreased pain threshold (P<0.01) versus the normal group.
Results
Both warm needling moxibustion and mild moxibustion improved function, joint swelling, and pain threshold in KOA rats relative to the model group.
Interventions were applied at 'Futu' (ST32) and 'Zusanli' (ST36), 30 min per session, once every other day for 4 weeks.
Both treatment groups had significantly lower Lequesne MG scores (P<0.01), reduced joint horizontal diameters (P<0.01), and increased pain thresholds (P<0.01) compared with the model group.
Results
Warm needling moxibustion outperformed mild moxibustion on Lequesne MG score and pain threshold, but not on knee joint horizontal diameter.
Compared with the mild moxibustion group, the warm needling group showed a lower Lequesne MG score (P<0.01) and a higher pain threshold (P<0.01).
The abstract states more significant changes in warm needling for all indicators 'except joint horizontal diameter'.
Results
Both moxibustion treatments reduced cartilage degeneration, with greater histological improvement from warm needling.
The model group showed degenerative features including damage to the superficial cartilage layer and disappearance of the tidemark (HE and safranin O staining).
Mankin's and OARSI scores were significantly increased in the model group versus normal (P<0.01).
Both scores decreased in both treatment groups versus model (P<0.01).
Scores in the warm needling group were significantly lower than in the mild moxibustion group (P<0.05).
Results
KOA modeling raised serum inflammatory and cartilage-degrading markers, and both treatments lowered them, with warm needling showing greater effects.
Serum IL-6, IL-18, and MMP-13 measured by ELISA were significantly elevated in the model group versus normal (P<0.01).
Both treatment groups showed decreased serum IL-6, IL-18, and MMP-13 versus the model group (P<0.01).
Warm needling showed more significant changes than mild moxibustion in these indicators (P<0.01, P<0.05).
Results
KOA increased cartilage expression of senescence markers P16INK4A and P21Waf1/Cip1 and inflammatory/catabolic proteins while decreasing Collagen-II; both treatments reversed these changes.
In cartilage, P16INK4A, P21Waf1/Cip1, IL-6, and MMP-13 were increased in the model group (P<0.01), while Collagen-II expression was reduced (P<0.01), assessed by immunohistochemistry and Western blot.
Both treatment groups showed reduced expression of P16INK4A, P21Waf1/Cip1, IL-6, and MMP-13 (P<0.01, P<0.05) and increased Collagen-II expression (P<0.01) versus model.
Warm needling produced more significant changes than mild moxibustion in these indicators (P<0.01, P<0.05).
Conclusions
The authors conclude warm needling moxibustion is more effective than mild moxibustion for rat KOA, possibly via inhibiting chondrocyte senescence.
The conclusion is based on improved behavioral, histological, serum, and cartilage protein indicators.
The mechanism is described as 'may be associated with' inhibition of chondrocyte senescence, reflecting correlative rather than causal evidence.
What This Means
This study in rats looked at whether warm needling moxibustion, a traditional Chinese therapy in which a needle is inserted at an acupoint and heated with burning moxa, can help with knee osteoarthritis. Rats with chemically induced knee arthritis were treated at two acupoints near the knee every other day for 4 weeks, and were compared with untreated arthritic rats, healthy rats, and rats given mild moxibustion (heat without a needle).
Both treatments reduced limb dysfunction, joint swelling, and pain sensitivity, and lessened cartilage damage. They also lowered blood and cartilage levels of inflammatory and cartilage-breakdown molecules and of markers of cell aging (senescence) in cartilage cells, while increasing a key cartilage structural protein, type II collagen. Warm needling moxibustion generally showed bigger benefits than mild moxibustion, except for joint swelling, where the two did not clearly differ.
This research suggests that warm needling moxibustion may protect cartilage partly by slowing cartilage cell aging. However, this was an animal study using a chemically induced arthritis model, and the mechanism link is suggestive rather than proven. The results do not establish how well the treatment would work in people with knee osteoarthritis.
Feng T, Li J, Jia Y, Tao Y, Xu J. (2026). [Study on regulatory effects of warm needling moxibustion on chondrocyte senescence in rats with knee osteoarthritis].. Zhen ci yan jiu = Acupuncture research. https://doi.org/10.13702/j.1000-0607.20251035