Xiyan — The Eyes of the Knee

Star

膝眼 (Xī Yǎn)

Classical Prescriptions Pain — Knee

Classical; the standard local prescription for the knee.

Points

  1. ST35 Dubi affected side

    The lateral knee eye

  2. EX-LE4 Neixiyan affected side

    The medial knee eye

  3. EX-LE2 Heding affected side

    Above the patella; completes the frame

  4. GB34 Yanglingquan affected side

    Hui-Meeting of the sinews; added distally

  5. SP9 Yinlingquan affected side

    Resolves damp and swelling; the medial counterpart of GB34

Treatment Principle

Frame the joint locally and support it distally with the sinew and damp-resolving points.

Indications

Osteoarthritis of the kneeknee pain, swelling and stiffnessdifficulty flexing or extending the kneepatellofemoral painchronic knee effusion

Method

Flex the knee to about 90 degrees, supported with a bolster. Needle ST35 and Neixiyan obliquely into the joint space from each side, and Heding above the patella. Add GB34 and SP9. Moxa is useful over the joint in cold, damp presentations.

Needle order: The two knee eyes first, then Heding, then the distal points.

⚠ Cautions

An acutely hot, swollen knee, or one that locks or gives way after injury, needs assessment before local needling. Observe clean technique carefully — this is intra-articular territory.

About

The oldest and most durable local prescription for the knee, and still the standard opening in osteoarthritis.

Rationale

The two hollows either side of the patellar ligament give the only direct access to the joint line from the front. Framing the joint with three local needles and supporting it with GB34 — the Hui-Meeting of the sinews — and SP9 — for the swelling — treats the structure, its soft tissue and its fluid together.

Clinical Notes

Where the patient cannot tolerate local needling, Dr. Tan's elbow-images-knee approach on the opposite arm is the alternative, and permits weight-bearing movement during retention.

Sources

  • Deadman, Peter; Al-Khafaji, Mazin; Baker, Kevin. A Manual of Acupuncture.

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