The Study on Correlation between the KL-Grade and Improvement of Knee Pain Treated by Korean Medicine Therapy

KL-Grade의 정도와 슬관절 통증의 한의학적 치료 효과의 상관성 연구

  • Received : 2017.06.22
  • Accepted : 2017.06.30
  • Published : 2017.07.31


Objectives The purpose of this study is to compare the effects between the KL-Grade and improvement of knee pain treated by Korean Medicine therapy. Methods 114 patients who received inpatient treatment from July 2014 to May 2017 in the Daejeon Jaseng of Korean Medicine Hospital were divided into 5 groups by the KL-Grade. All patients received a combination of treatment including acupunture, pharmacopunture, herbal medication. They were compared and analyzed on the basis of improvement between measuring Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index), EuroQol-5 Dimension Index (EQ-5D Index) as they were hospitalized and as they were discharged. The statistically significance was evaluated by SPSS 23.0 for windows. Results After treatment, KL-Grade 0 group's Numeric Rating Scale (NRS), Western Ontario and McMaster Universities Arthritis Index (WOMAC Index), EuroQol-5 Dimension Index (EQ-5D Index) improvement was $2.02{\pm}1.69$, $7.50{\pm}9.67$ and $0.11{\pm}0.15$ respectively. KL-Grade 1 group's improvement was $2.09{\pm}1.23$, $11.75{\pm}13.99$ and $0.12{\pm}0.13$ respectively. KL-Grade 2 group's improvement was $1.60{\pm}1.07$ and $14.70{\pm}14.19$ respectively. But In this group, EQ-5D Index has decreased by $0.01{\pm}0.10$. KL-Grade 3 group's improvement was $1.88{\pm}1.31$, $7.81{\pm}13.35$ and $0.13{\pm}0.20$ respectively (p<0.034). In the case of KL-Grade 4, the population was not statistically significant (N=2) and therefore excluded from statistical significance. And there was no statistically significance between 4 group's improvement after treatment (p>0.05). Conclusions The above study showed that Korean medicine treatments showed significant therapeutic effects on knee pain and degenerative knee joints, but there was no significant difference in the effectiveness of degenerative arthritis (KL-Grade).


Acupuncture;Korean Medicine;Osteoarthritis;Knee pain;KL-Grade


  1. Gang HS, HongSH, Gang CH. Musculoskeletal radiology 1st edition. Seoul, Bummun Education. 2013;811-5.
  2. Han TR, Bang MS. Third Rehabilitation Medicine. Seoul, Koonja. 2011;501-10.
  3. The Korean Orthopaedic Association. Orthopedics 6th edition. Seoul, ChoiSin medical Publishing Co. 2006;686, 714-7.
  4. Tramer MR, Moore RA, Reynolds DJ, McQuay HJ. Quantitative estimation of rare adverse events which follow a biological progression: a new model applied to chronic NSAID use. Pain. 2000;85:169-82.
  5. Juni P, Reichenbach S, Egger M. COX 2 inhibitors, traditional NSAIDs, and the heart. BMJ. 2005;330:1342-3.
  6. Wall PD, Mozack Ronald. Textbook of PAIN. Seoul, Jungdam Publication. 2002:483-4.
  7. Jung CY, Kim EJ, Hwang MS, Cho HS, Kim KH, Lee SD, Kim KS. The Research of Pain and Functional Disability Assessment Scales for Knee Joint Disease. The Acupuncture. 2010;27(2):123-42.
  8. Lee YK, Nam HS, Chuang LH et al. South Korean Time Trade-Off Values for EQ-5D Health States: Modeling with Observed Values for 101 Health States. Value Health. 2009;12(8):1187-93.
  9. Lee SI. Validity and reliability evaluation for EQ-5D in Korea. Korea Centers for Disease Control and Prevention. 2012-08-04. URL:
  10. Health Insurance Review&Assessment Service. Clinical Statistical Statistics Index. 2017 The first quarter of the year Statistics Index. 2017;8-13 .
  11. Kim EJ, Lim CY, Lee EY et al. Comparing the effects of individualized, standard, sham and no acupuncture in the treatment of knee osteoarthritis. Trials. 2013;14:129.
  12. Park KM, Cho TH. Therapeutic effect of acupuncture point injection with placental extract in knee osteoarthritis. J Integr Med. 2017 Mar;15(2):135-41.
  13. Seo BK, Sung WS, Park YC et al. The electroacupuncture-induced analgesic effect mediated by 5-HT1, 5-HT3 receptor and muscarinic cholinergic receptors in rat model of collagenase-induced osteoarthritis. BMC Complement Altern Med. 2016 Jul 13;16:212.
  14. Fu NN, Li XZ, Yang XG et al. Effect of Electroacupuncture with Near-to-bone Needling to Chondrocyte Apoptosis and Proliferation on the Knee Osteoarthritis Model. Sichuan Da Xue Xue Bao Yi Xue Ban. 2016 Sep;47(5):708-13.
  15. Ezzo J1, Hadhazy V, Birch S et al. Acupuncture for osteoarthritis of the knee. Arthritis Rheum. 2001 Apr;44(4):819-25.<819::AID-ANR138>3.0.CO;2-P
  16. Vas J, Mendez C, Perea-Milla E et al. Acupuncture as a complementary therapy to the pharmacological treatment of osteoarthritis of the knee. BMJ. 2004 Nov 20; 329(7476):1216.
  17. Weiner DK, Moore CG, Morone NE et al. Efficacy of periosteal stimulation for chronic pain associated with advanced knee osteoarthritis. Clin Ther. 2013 Nov; 35(11):1703-20.
  18. National Health Insurance Service, Health Insurance Review and Assessment Service. Benefits by Classification of 298 Disease Categories by Age(Total). 2013 Health Insurance Statistical Yearbook. 2014:376-555.
  19. Li Qi, Yonggang Tang, Yong You et al. Comparing the Effectiveness of Electroacupuncture with Different Grades of Knee Osteoarthritis. Cell Physiol Biochem. 2016;39: 2331-40.