Smart Functionalization of Acupuncture Needle Enables Molecular Subtyping and Personalized Treatment of Osteoarthritis

Osteoarthritis (OA) is a heterogeneous disorder with a rising global prevalence, largely driven by aging and obesity, and it imposes a significant worldwide health burden. Current therapeutic strategies, limited to transient lubrication or pain relief, are unable to halt disease progression due to their failure to repair cartilage. To address this challenge, we developed an integrated theranostic platform using a modified acupuncture needle with helical microgrooves. These grooves are loaded sequentially with three functional hydrogel segments. The degradation of each segment triggers the controlled release of a corresponding therapeutic agent: Batimastat, Etodolac, and Docetaxel. Each hydrogel is engineered to respond specifically to a key OA pathological pathway: matrix degradation (MMP13-responsive), inflammation (ADAMTS5-responsive), and fibrosis (TGF-β-responsive), and is labeled with a distinct fluorescent marker (Cy5, FITC, or Cy5). The core innovation of this system is its capacity for simultaneous diagnosis and treatment. After implantation, the needle can be retrieved, and the degradation status of each hydrogel segment assessed by fluorescence imaging, providing a post-treatment readout of the dominant OA molecular subtype. Collectively, this multifunctional platform, termed helical-groove acupuncture needle (HGN), represents a promising strategy to curtail OA progression by simultaneously promoting cartilage restoration and inhibiting fibrotic changes.