膝骨关节炎(KOA)是导致中老年人慢性疼痛、摔倒致残的最主要原因。近年来国内外研究证明膝关节肌肉力量、功能减退是KOA发病的重要因素，关节骨性受损是其根本原因。本课题前期工作研究发现，推拿可减轻KOA患者疼痛，改善其关节功能活动，与肌肉形态结构及骨性改变相关，因此，提出了“推拿手法干预—膝周肌肉力学性能软骨结构改善—局部生物力学环境改善—膝关节功能活动改善”通道起作用的科学假说。本研究旨在从膝周肌肉力学性能、软骨细胞基因表达等层面进行研究，揭示推拿手法治疗KOA的作用机制。.本研究分两部分，以推拿手法干预KOA动物模型，观察手法对膝周肌肉组织结构生物力学指标，软骨细胞基因表达情况；以推拿手法治疗KOA患者后，MRI检测肌肉软骨结构，表面肌电图、肌力及症状功能变化情况。依托现代先进科学检测技术，遵循循证医学原则及临床实况随机设计研究，为进一步的临床及科研提供新的实验和理论支撑。

Knee osteoarthritis (KOA) is the leading cause of chronic pain and disability in the elderly. In the early stage study, we found that Tuina can relieve the pain of KOA patients, improve their functional activities and joint stability, and related to the changes of muscle morphology and bone structure. Therefore, we put forward a scientific hypothesis that Tuina intervention can improve cartilage structure, improve mechanical properties, environmental characteristics of local biomechanics, then improve the knee function activities. .This study is to observe the knee muscle tissue ultrastructure, biomechanical properties, gene expression of cartilage cells; the anatomical, physiological, biochemical and biomechanics change of the knee muscles and ligaments by Tuina intervene KOA animals,observe MRI detection of muscle cartilage structure, changes in surface EMG, muscle function and symptoms with Tuina therapy in KOA patients. Based on the modern advanced scientific testing technology, follow the principle of evidence-based medicine and clinical experience of random design research, for further clinical and scientific research to provide new experimental and theoretical support.The completion of this project can enrich and improve the basic theory of (TCM) traditional Chinese medicine Tuina, and provide new experimental parameters and theoretical basis for further clinical and scientific research of KOA. The research results can be used to promote (TCM) traditional Chinese medicine Tuina as a comprehensive treatment of KOA disease prevention and treatment, to reduce the amount of drug use and side effects, reduce medical costs, improve the effectiveness of the promotion and application.