ACUPUNCTURE TREATMENT FOR RIGHT HIP OSTEOARTHRITIS AS A COMPLICATION OF LEFT HIP CONGENITAL DISLOCATION – A CASE REPORT

ACUPUNCTURE TREATMENT FOR RIGHT HIP OSTEOARTHRITIS AS A COMPLICATION OF LEFT HIP CONGENITAL DISLOCATION – A CASE REPORT

C. Geetha, R. Subbulakshmi * and S. Supriya

Department of Anatomy, Vivekanadha Dental College for Women, Elayampalayam, Tiruchengode, Nammakal, Tamil Nadu, India.

ABSTRACT: Osteoarthritis in the hip creates a major cause of pain and functional limitation. Acupuncture is an effective treatment for reducing inflammation and protecting muscles and produce pain control associated with disorder. Acupuncture is a proven, comprehensive method that helps to restore normal body function. The aim of this study is to find out the effect of acupuncture for relieving chronic hip pain. Here we report a 45-year-old female presenting with swelling, redness and pain on the right hip and with left hip congenital dislocation and eventually diagnosed as right hip osteoarthritis. X-ray showed superior congenital dislocation of left hip.  The patient was treated with the selected acupoints ST44, ST36, UB 32, UB 35, UB 40, GB 32, LI4, LI11, DU20, P6, UB60, UB11, and GB34 for half an hour in alternate day for one week and then 15 days once followed for 6 months. VAS was used to measure pain. After treatment, the patient showed improvement in pain and functional ability. The patient is under regular check up.

Keywords: Congenital dislocation, Osteoarthritis, Acupoints, VAS

INTRODUCTION: Osteoarthritis (OA) affects all the major weight bearing joints and the hip is the second most commonly affected joint after knee joint ^{1, 2}. The treatment of hip OA is usually with drug therapies, but this may cause side effects. Hence, it is important to evaluate the effectiveness of acupuncture. According to acupuncture therapy, acupoints are stimulated with fine needles that may reduce pain and improve functional abilities. In acupuncture, hip osteoarthritis is called Bi syndrome and occurs due to stagnation of blood and qi (life force energy) resulting pain and stiffness in the muscles and joints.

Pathogenic factors like wind, cold and heat may cause blockage of energy moving freely throughout the body. If there is imbalance in the organs like kidneys, gall bladder, spleen and stomach that results in Bi syndrome hip. Acupuncture treatment mainly focus on removing the blockage and reducing pain signals by increasing the production of endorphins in the body, this helps in reducing inflammation ³.

Congenital dislocation of hip is also called as developmental dysplasia of the hip (DDH), is a condition where the ball and socket joint is not properly developed. This results in the child’s first year of life. Hip joint is a ball and socket joint is formed by the articulation of head of femur with the acetabulum (articular part) of hip bone. Symptoms of hip dysplasia includes groin pain or on the side or back of hip joint. This condition may be treated conservatively or surgically.

In our patient, congenital dislocation was treated conservatively and this later resulted in complication of right hip osteoarthritis. This patient was treated with the selected acupoints includes acupoints on lowerlimb: ST44, ST36, UB32, UB35, UB40, GB32, general immunity points: LI4, LI11, DU20, P6, Bone point: UB60, UB11, Muscle point: GB34. The pain intensity was measured by using the VAS. Acupuncture treatment helps in reduce inflammation and pain in the hip osteoarthritis by strengthening qi and muscles around hip joint.

Case Report: A 45-year-old married female patient presented with right hip joint severe pain. The patient’s weight was 68kg and her blood pressure was 130/80 mm Hg.

On physical examination, we noted there was swelling, hot and severe pain on the right hip with movement restriction. The patient also had left congenital dislocation on the left and was eventually diagnosed with right hip osteoarthritis.  X-ray hip showed superior congenital dislocation.

FIG. 1: X-RAY SHOWING RIGHT HIP OSTEOARTHRITIS AND LEFT CONGENITAL DISLOCATION

This patient was treated with the selected acupoints included acupoints on lowerlimb: ST44, ST36, UB32, UB35, UB40, GB32, general immunity points: LI4, LI11, DU20, P6, Bone point: UB60, UB11, Muscle point: GB34. The pain intensity was measured by using the VAS. After treatment, the patient showed improvement in pain and functional ability. The patient is under regular check up.

DISCUSSION: Osteoarthritis (OA) is a disease affecting the joints, and the second common joint to be affected is the hip joint. Hip osteoarthritis is commonly treated with drug therapies, but it may rarely produce few side effects. According to acupuncture therapy, in the body the acupoints are stimulated by inserting very thin needles to reduce pain or gain functional ability. Research on animal studies showed that acupuncture treatment stimulates the nervous system that releases neurotransmitters mainly opioid peptides which suppress the pain in the body ⁴. Because pain often limits the daily functional activity of patients and also some studies proved that acupuncture therapy reduces inflammation ⁵. Reduction in pain and inflammation improves patient functional ability.

For hip osteoarthritis the acupuncture therapist selected the following acupoints like the common points of GB 30, GB 29, and closer to the sacrum at Bl 53 and Bl 54. Other local and adjacent points include GB 29, GB 30, Bl 53, and Bl 54 ⁶. In our study, we selected acupoints on lowerlimb: ST44, ST36, UB32, UB35, UB40, GB32, general immunity points: LI4, LI11, DU20, P6, Bone point: UB60, UB11, Muscle point: GB34. Zheng, A et al used Visual Analog Scale to measure the intensity of pain in patients with knee osteoarthritis after acupuncture therapy ⁷. In our study we also used Visual Analog Scale to measure the intensity of pain after acupuncture treatment.

CONCULSION: The acupuncture therapy for hip osteoarthritis is useful for reducing the pain, this may improve the functional ability of the patient. Hence, suggesting that acupuncture treatment can be used as an alternative therapy for treating hip osteoarthritis.

ACKNOWLEDGEMENT: Nil

CONFLICTS OF INTEREST: Nil

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   How to cite this article:

   Geetha C, Subbulakshmi R and Supriya S: Acupuncture treatment for right hip osteoarthritis as a complication of left hip congenital dislocation – a case report. Int J Pharm Sci & Res 2024; 15(9): 2788-90. doi: 10.13040/IJPSR.0975-8232.15(9).2788-90.

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