OBJECTIVE To investigate the intervention effects of tissue-bone homeostasis manipulation (TBHM) on peripatellar biomechanical parameters and knee joint function in knee osteoarthritis (KOA) patients.

METHODS Sixty patients with KOA (Kellgren-Lawrence grade Ⅱ-Ⅲ) were recruited from the Acupuncture-Moxibustion Rehabilitation Department, Anhui University of Chinese Medicine between October 2024 and May 2025. Participants were randomized into a TBHM group (n=30) or a transcutaneous electrical neuromuscular stimulation (TENS) group (n=30). Using two-way repeated measures ANOVA, biomechanical indicators, including rectus femoris tension, vastus medialis tension, vastus lateralis tension, patellar ligament tension, lateral patellar displacement (LPD), medial patellar displacement (MPD), normalized patellar mobility (LPD/patellar width PW, MPD/PW), knee flexion range of motion, and functional indicators, including KOOS subscales, time up and go test (TUGT), were compared between groups at baseline and after 6 weeks of intervention.

RESULTS After intervention, all biomechanical and knee joint function indicators in the TBHM group were significantly improved (P < 0.05, P < 0.01), while only the vastus medialis tension, TUGT and KOOS Pain, ADL and QoL scores in the control group were significantly improved (P < 0.01). The improvement amplitudes of biomechanical indicators in the TBHM group, including rectus femoris tension, vastus lateralis tension, patellar ligament tension, MPD/PW, LPD/PW and knee flexion range of motion were better than those in the control group (P < 0.05, P < 0.01). In the functional evaluation, the interaction effects of the TBHM group in all dimensions of the KOOS score and TUGT were statistically significant(P < 0.05, P < 0.01). Post-hoc simple effect analysis confirmed that there were significant differences in the above indicators between the two groups after intervention (P < 0.05), and all indicators showed a significant main effect of time (P < 0.01), suggesting that the intervention measures had continuous and cumulative curative effects.

CONCLUSION TBHM effectively improves joint function and quality of life in KOA patients by restoring dynamic equilibrium in soft tissue tension and patellar mobility, ultimately achieving the therapeutic goal of concurrent tissue-bone management.