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Review
. 2021 Jul 19:14:2209-2228.
doi: 10.2147/JPR.S315956. eCollection 2021.

Efficacy of Acupuncture-Related Therapy in the Treatment of Knee Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials

Wei Liu #  1   2 , Yihua Fan #  1   2 , Yuanhao Wu #  1   2 , Xu Hou  3 , Bin Xue  1   2 , Peihao Li  1   2 , Shumin Zhang  1   2 , Qingyun Yue  1   2
Affiliations
Review

Efficacy of Acupuncture-Related Therapy in the Treatment of Knee Osteoarthritis: A Network Meta-Analysis of Randomized Controlled Trials

Wei Liu et al. J Pain Res. .

Abstract

Objective: Knee osteoarthritis (KOA) is prevalent in middle-aged and elderly people. This condition negatively affects the quality of life of patients. Although non-steroidal anti-inflammatory drugs (NSAIDs) are often used to relieve symptoms associated with KOA, it is associated with many side effects. Acupuncture and moxibustion therapies have been applied in the treatment of KOA. However, the efficacy of various acupuncture and moxibustion treatments has not been compared.

Methods: Randomized controlled trials (RCTs) on the application of acupuncture and moxibustion in the treatment of KOA were searched in English databases and Chinese databases. Data were retrieved from establishment of the database to September 2020. Data analysis was performed using Stata14.0 and GeMTC 0.14.3 softwares.

Results: A total of 40 RCTs involving 3215 patients with KOA were retrieved. Network meta-analysis revealed that the fire needle was superior to western medicine, electro-acupuncture, conventional acupuncture, warm needle and sham acupuncture; warm needle was better than conventional acupuncture and western medicine whereas electro-acupuncture was better than conventional acupuncture in improving pain scores in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Moreover, we found that fire needle and warm needle more effectively improved WOMAC stiffness scores than western medicine and sham moxibustion, whereas electro-acupuncture was superior to western medicine and sham moxibustion in improving WOMAC stiffness scores. Further analysis revealed that fire needle, warm needle and electro-acupuncture were more effective in improving WOMAC joint function scores than conventional acupuncture and western medicine. The fire needle was superior to conventional acupuncture and sham acupuncture, whereas electro-acupuncture was better than western medicine, conventional acupuncture and sham acupuncture in improving visual analogue scale scores.

Conclusion: This study shows that fire needle is superior to warm needle and electro-acupuncture, whereas warm needle and electro-acupuncture are better than conventional acupuncture, western medicine, sham moxibustion and sham acupuncture.

Keywords: acupuncture; knee osteoarthritis; moxibustion; network meta-analysis; randomized controlled trials.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Flowchart of study screening.
Figure 2
Figure 2
Evaluation results of bias risk.
Figure 3
Figure 3
Evidence network diagram of WOMAC pain score for different acupuncture treatments for knee osteoarthritis.
Figure 4
Figure 4
Evidence network diagram of a WOMAC stiffness score for different acupuncture treatments for KOA.
Figure 5
Figure 5
Evidence network diagram showing WOMAC joint function score for different acupuncture treatments for KOA.
Figure 6
Figure 6
Evidence network diagram of VAS score for different acupuncture treatments for KOA.
Figure 7
Figure 7
WOMAC pain score comparison corrected funnel plots of different acupuncture treatments for KOA.
See this image and copyright information in PMC

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References

    1. Dawson J, Linsell L, Zondervan K, et al. Impact of persistent hip or knee pain on overall health status in elderly people: a longitudinal population study. Arthritis Rheum. 2005;53(3):368–374. doi:10.1002/art.21180 - DOI - PubMed
    1. Palmer KT, Reading I, Calnan M, Linaker C, Coggon D, Palmer KT, Reading I, Calnan M, et al. Does knee pain in the community behave like a regional pain syndrome? Prospective cohort study of incidence and persistence. Ann Rheum Dis. 2007;66(9):1190–1194. doi:10.1136/ard.2006.061481 - DOI - PMC - PubMed
    1. Avendaño-Coy J, Comino-Suárez N, Grande-Muñoz J, et al. Extracorporeal shockwave therapy improves pain and function in subjects with knee osteoarthritis: a systematic review and meta-analysis of randomized clinical trials. Int J Surg. 2020;82:64–75. doi:10.1016/j.ijsu.2020.07.055 - DOI - PubMed
    1. Lu YH, Shi XB. Current status and progress of epidemiological studies on knee osteoarthritis. Chine J Traditional Med Traumatology Orthopedics. 2012;20(6):81–84.
    1. Blagojevic M, Jinks C, Jeffery A, et al. Risk factors for onset of osteoarthritis of the knee in older adults: a systematic review and meta-analysis. Osteoarthritis Cartilage. 2010;18(1):24–33. doi:10.1016/j.joca.2009.08.010 - DOI - PubMed

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