Electroacupuncture superiority in knee osteoarthritis: a meta-analysis of four acupuncture techniques

Abstract

Background: Knee osteoarthritis is the most prevalent chronic joint disease affecting persons >50 years, which significantly impairs the patients' lives. Although acupuncture can treat knee osteoarthritis; none of the studies have compared the effectiveness of four common acupuncture techniques (electroacupuncture, filiform acupuncture, warming acupuncture, and fire acupuncture) in knee osteoarthritis.

Methods: The Web of Science, EMBASE, PubMed, Scopus, and CNKI databases were searched for the clinical randomized controlled trials of electroacupuncture, filiform acupuncture, warming acupuncture, and fire acupuncture in the treatment of knee osteoarthritis published before September 1, 2024. We collected 52 studies and used R software to analyze data.

Results: The results of meta-analysis showed that the efficacy rates for electroacupuncture, filiform acupuncture, warming acupuncture, and fire acupuncture were 91.5, 83.4, 84.9, and 83.5%, respectively. The respective visual analog scale (VAS) scores were 2.1, 3.2, 2.9, and 4.1, respectively. Moreover, the patient's age and body mass index (BMI) can negatively affect the efficacy rate of acupuncture therapies, whereas age and BMI positively impacts the VAS scores.

Conclusion: Thus, our study suggests that electroacupuncture has the best clinical efficacy for knee osteoarthritis; however, patients' age and BMI should be considered in future acupuncture therapies.

Keywords: acupuncture; body mass index; electroacupuncture; knee osteoarthritis; systematic review.

Figure 1

PRISMA flow chart showing the study selection procedure.

Figure 2

Comparisons between the clinical efficacies of different acupuncture therapies. (a) Effective rates, and (b) Visual analog scale (VAS) scores. Different lowercase letters indicate significance among acupuncture therapies.

Figure 3

Associations between the clinical efficacies of various acupuncture therapies and age. (a) Effective rates (electroacupuncture: y = −0.22x + 101.80; filiform acupuncture: y = −0.57x + 117.03; warming acupuncture: y = −0.52x + 116.70, and fire acupuncture: y = −0.02x + 84.60), and (b) Visual analog scale (VAS) scores (electroacupuncture: y = 0.03x + 0.71; filiform acupuncture: y = 0.07x – 0.79; warming acupuncture: y = 0.05x – 0.36, and fire acupuncture: y = −0.02x + 5.68). Colored lines and shaded areas represent the fitted lines and 95% confidence intervals, respectively. Supplementary Table S2 demonstrates detailed information about regression models.

Figure 4

Relationships between the clinical efficacies of various acupuncture therapies and BMI. (a) Effective rates (electroacupuncture: y = −1.17x + 114.33; filiform acupuncture: y = −1.27x + 113.07; warming acupuncture: y = −1.50x + 117.37, and fire acupuncture: y = −0.19x + 87.85), and (b) Visual analog scale (VAS) scores (electroacupuncture: y = 0.14x – 0.59; filiform acupuncture: y = 0.13x + 0.17; warming acupuncture: y = 0.21x – 1.76, and fire acupuncture: y = 0.03x + 3.45). Colored lines and shaded areas represent the fitted lines and 95% confidence intervals, respectively. Supplementary Table S3 provides comprehensive details regarding regression models.