Chao Zhang,1,2,* Hongfei Xue,1,2,* Jiankang Xu,1,2,* Aifeng Liu,1,2 Kuiliang Gao,1,2 Longyao Zhang1,2 

1Orthopedics Department, The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China; 2National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Longyao Zhang, Orthopedics Department, The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China, Email 478650625@qq.com Kuiliang Gao, Orthopedics Department, The First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, People’s Republic of China, Email gyu2202@163.com

Background: Knee osteoarthritis (KOA) is a prevalent degenerative joint disease that significantly impacts pain and mobility. Acupuncture targeting Myofascial Trigger Points (MTrPs), guided by the “pain as acupoint” strategy, has been proposed as a more precise intervention approach.
Objective: This study aims to compare the efficacy of MTrP acupuncture versus conventional acupuncture in patients with early- to mid-stage KOA.
Methods: In this assessor-blinded randomized controlled trial, 106 KOA patients (Kellgren–Lawrence grade II/III) will be randomly assigned (1:1) to receive either conventional meridian-based acupuncture (Group A) or acupuncture targeting both meridian points and MTrPs (Group B). Both groups will receive treatment five times weekly for two weeks. The primary outcome is the response rate, defined as a ≥ 2-point reduction in VAS and ≥ 6-point improvement in WOMAC function score. Secondary outcomes include pressure pain threshold (PPT), three-dimensional gait analysis, and patient acceptability.
Results: This study is expected to demonstrate whether MTrP acupuncture provides superior pain relief and functional improvement compared to conventional acupuncture.
Conclusion: Findings will contribute novel clinical evidence for optimizing individualized acupuncture strategies in the management of KOA.
Trial Registration: ChiCTR, ChiCTR2300073707, Registered on July 19, 2023.

Keywords: knee osteoarthritis, acupuncture, myofascial trigger points, individualized treatment, clinical trial