Professor Wu Guanbao’s Experience in the Treatment of Spontaneous Osteonecrosis of the Knee Based on the Theory that “the Kidney Governs Bone and Generates Marrow”

Corresponding author: Wu Guanbao, yhywgb@126.com

DOI: 10.12201/bmr.202604.00074

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  Abstract: Spontaneous osteonecrosis of the knee is mainly characterized by knee pain and impaired weight-bearing function. Early diagnosis relies largely on magnetic resonance imaging, while conservative treatment still has limitations, including a relatively long treatment course and insufficient structural protection. Based on the theory in the Huangdi Neijing that “the kidney governs bone and marrow,” and in combination with clinical experience, this paper proposes that the disease is characterized by a pattern of deficiency in origin and excess in superficiality, with deficiency of kidney essence and marrow as the root and collateral stasis with bony impediment as the manifestation. The key site of the lesion is considered to be the subchondral bone–bone marrow region. Treatment should focus on tonifying the kidney, replenishing marrow, and strengthening the sinews and bones, supplemented by promoting blood circulation, unblocking the collaterals, and relieving pain, with flexible modification according to disease stage and syndrome evolution. The presented case suggests that this approach can alleviate pain and improve knee joint function, and may provide a reference for the traditional Chinese medicine treatment of spontaneous osteonecrosis of the knee.

  Key words: spontaneous osteonecrosis of the knee; the kidney governs bone and generates marrow; tonifying the kidney and replenishing marrow; famous physician’s experience

  Submit time: 10 April 2026

  Copyright: The copyright holder for this preprint is the author/funder, who has granted biomedRxiv a license to display the preprint in perpetuity.
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  1	2026-03-13	10.12201/bmr.202604.00074V1	Download

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