Therapeutic use of Mechanised Shringayantra for Knee Osteoarthritis (Janusandhigata Vata): A Retrospective Observational Case Series of a Pressure-Controlled Mechanical Vacuum Adaptation of a Classical Ayurvedic Bloodletting Instrument

Abstract

Knee Osteoarthritis (KOA) is a leading cause of disability globally, affecting 22–39% in Indian adults, and is correlated with Janu Sandhigata Vata in Ayurveda. Shringayantra a horn-based suction device is used for Raktamokshana (therapeutic bloodletting) in Vataja Shoola (mechanical pain), but oral aspiration procedure is unhygienic and non-reproducible. This case series reports retrospective clinical outcomes following a modified Shringayantra that replaces oral suction with a calibrated vacuum pump in this pilot study. Methods: A retrospective, observational case series was conducted by chart review of the patients treated at Samadhan Ayurveda Panchakarma Hospital, Nagpur (2025–26). Eighteen consecutive patients diagnosed with knee osteoarthritis (Janu Sandhigata Vata) and treated with modified Shringayantra were retrieved and analysed. Pre- treatment (BT) and post-treatment (AT) scores for five clinical parameters pain (Shoola), swelling (Shotha), crepitation, walking pain, and stiffness (Graha) were recorded on a 0–4 ordinal scale and compared using Wilcoxon Signed-Rank Test was applied (p<0.05). Results: Significant reductions were recorded across all parameters (p≤0.002). Mean pain score declined from 2.89±0.68 to 0.56±0.51. Overall: Marked relief (≥75%)- 53.33%; Moderate response- 40.00%; Mild improvement- 6.66%; No response- 0%. No adverse events were recorded. Conclusion: The retrospective chart-review data suggest the modified Shringayantra is a safe, effective, and standardisable non-pharmacological intervention for knee OA. Randomised controlled trials are warranted.