1. J Bone Joint Surg Am. 2016 Sep 21;98(18):1578-85. doi: 10.2106/JBJS.15.00620.

The Effects of Acupuncture on Chronic Knee Pain Due to Osteoarthritis: A
Meta-Analysis.

Lin X(1), Huang K(1), Zhu G(2), Huang Z(1), Qin A(3), Fan S(4).

Author information: 
(1)Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Medical College 
of Zhejiang University, Hangzhou, People's Republic of China.
(2)Department of Orthopaedic Surgery, First Affiliated Hospital of Wenzhou
Medical University, Wenzhou, People's Republic of China.
(3)Department of Orthopaedics, Shanghai Key Laboratory of Orthopaedic Implants,
Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of
Medicine, Shanghai, People's Republic of China.
(4)Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, Medical College 
of Zhejiang University, Hangzhou, People's Republic of China shunwu_fan@126.com.

BACKGROUND: Acupuncture reportedly relieves chronic knee pain and improves
physical function in patients diagnosed with osteoarthritis, but the duration of 
these effects is controversial. The aim of this study was to evaluate the
temporal effects of acupuncture on chronic knee pain due to knee osteoarthritis
by means of a meta-analysis.
METHODS: The PubMed, Embase, and Cochrane Central Register of Controlled Trials
databases were searched for studies published through March 2015. Ten randomized 
controlled trials of acupuncture compared with sham acupuncture, usual care, or
no intervention for chronic knee pain in patients with clinically diagnosed or
radiographically confirmed knee osteoarthritis were included. All of the studies 
were available in English. Weighted mean differences (WMDs), 95% confidence
intervals (CIs), publication bias, and heterogeneity were calculated.
RESULTS: The acupuncture groups showed superior pain improvement (p < 0.001; WMD 
= -1.24 [95% CI, -1.92 to -0.56]; I(2) > 50%) and physical function (p < 0.001;
WMD = 4.61 [95% CI, 2.24 to 6.97]; I(2) > 50%) in the short term (up to 13
weeks). The acupuncture groups showed superior physical function (p = 0.016; WMD 
= 2.73 [95% CI, 0.51 to 4.94]; I(2) > 50%) but not superior pain improvement (p =
0.199; WMD = -0.55 [95% CI, -1.39 to 0.29]; I(2) > 50%) in the long term (up to
26 weeks). Subgroup analysis revealed that the acupuncture groups tended to have 
better outcomes compared with the controls. Significant publication bias was not 
detected (p > 0.05), but the heterogeneity of the studies was substantial.
CONCLUSIONS: This meta-analysis demonstrates that acupuncture can improve short
and long-term physical function, but it appears to provide only short-term pain
relief in patients with chronic knee pain due to osteoarthritis.
LEVEL OF EVIDENCE: Therapeutic Level I. See Instructions for Authors for a
complete description of levels of evidence.

Copyright © 2016 by The Journal of Bone and Joint Surgery, Incorporated.

DOI: 10.2106/JBJS.15.00620 
PMID: 27655986  [Indexed for MEDLINE]