Clinical Applicability of Pharmacopuncture Therapy for Osteoarthritis: A Narrative Review Focused on Drug Delivery Systems and Herbal Component Mechanisms

Osteoarthritis (OA), a prevalent degenerative joint disease, is characterized by cartilage degradation, synovial inflammation, and subchondral bone changes.Current clinical treatments primarily focus on symptom relief; however, they fail to modify disease progression or promote cartilage regeneration.This narrative review evaluates the therapeutic potential of natural bioactive compounds and advanced drug delivery systems (DDS), focusing on their applicability through pharmacopuncture.A comprehensive analysis of in vitro and in vivo studies was conducted, which evaluated herbal pharmacopuncture solutions, such as curcumin, icariin, rhein, salicin, and arctiin.Biomaterial-based DDS platforms were loaded, including hydrogels, microspheres, and metal-organic frameworks.The therapeutic effects on OA were analyzed from the perspective of disease-modifying OA drugs, including anti-inflammatory, antioxidative, chondroprotective, and regenerative actions.Herbal pharmacopuncture solution exerted robust anti-inflammatory, antioxidative, and chondroprotective effects by regulating cytokine expression, inhibiting the action of matrix-degrading enzymes, and restoring mitochondrial function.DDS platforms effectively sustained intra-articular retention, promoted bioavailability, and allowed for the targeted modulation of OA pathology.Pharmacopuncture using these systems yielded promising outcomes in preclinical models.Integrating herbal pharmacopuncture and advanced DDS offers a novel therapeutic strategy for OA, which shifts the treatment paradigms from symptomatic relief toward true disease modification.Further studies needed to confirm efficacy.