Insights & Discussion
According to high-quality outcomes, acupuncture had more total effective rate, short-term effective rate, and less adverse reactions than western medicine in treating knee osteoarthritis.
Firstly, this overview provides the latest evidence on acupuncture for knee osteoarthritis based on the findings of systematic reviews, which indicated that acupuncture may have more total effective rate, short-term effective rate, and less adverse reactions in treating knee osteoarthritis than western medicine. Secondly, this overview is predesigned, which helps restrict the likelihood of biased decisions in reviewing. Thirdly, comprehensive search strategies were conducted for a wide range of data. Fourthly, independent reviewers were engaged in searching, screening, and assessing the potential studies and there was a high consistency among the reviewers.
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Moxibustion, a form of traditional Chinese medicine, appears to be an effective and safe treatment for knee osteoarthritis.
2022 Frontiers in Physiology An Overview of Systematic Reviews of Moxibustion for Knee Osteoarthritis Yin S, Zhu F, Li Z, Che D, Li L, Feng J, et al.
Systematic Review Knee Osteoarthritis Moxibustion
The researchers used a series of databases including Embase, PubMed, Web of Science, Cochrane Library, and others to carry out a comprehensive evaluation of previous systematic reviews on the treatment of knee osteoarthritis with moxibustion. They employed the Measurement Tool to Assess Systematic Reviews 2 to assess the methodological quality, Preferred Reporting Item for Systematic Reviews and Meta-analyses for reporting quality, and ROBIS Tool to evaluate the risk of bias in the systematic reviews. They also assessed the strength of evidence with the Grading of Recommendations Assessment, Development and Evaluation tool and carried out a meta-analysis of the total effectiveness rate.
From this process, 10 systematic reviews were selected that had met their criteria. These reviews included the results of 57 randomized controlled trials involving a total of 5,149 participants. However, these reviews were found to have several critical deficiencies, scoring low on the quality scale used. Despite this, moxibustion, and its combination treatment, were shown to improve the total effectiveness rate in knee osteoarthritis. Eight of the reviews had reported adverse events but none were classified as serious in either the moxibustion group or control group.
Turmeric curcuminoids are associated with better pain relief than NSAIDs in knee osteoarthritis.
2021 Complementary Therapies in Medicine The efficacy of high- and low-dose curcumin in knee osteoarthritis: A systematic review and meta-analysis An-Fang Hsiao, Yi-Chieh Lien, I-Shiang Tzeng, Chien-Ting Liu, Sheng-Hsun Chou, Yi-Shiung Horng
Systematic Review Arthritis Knee Osteoarthritis Turmeric
The meta-analysis results showed that curcuminoids were significantly more effective than comparators regarding visual analogue scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain scores.
However, no significant difference in pain relief or AEs between the high-dose (daily dose ≥1000 mg or total dose ≥42 gm) and low-dose (daily dose <1000 mg or total dose <42 gm) curcuminoid treatments was observed.
When comparing curcumininoids versus NSAIDs, a significant difference in VAS pain was found. For AE analysis, three of our included studies used NSAIDs as comparators, with all reporting higher AE rates in the NSAID group, though significance was reached in only one study.
Pomegranate peel extract supplementation can decrease total cholesterol and triglyceride levels while boosting antioxidant status in obese women with knee osteoarthritis.
2021 Advances in Integrative Medicine Effects of pomegranate (Punica granatum L.) peel extract supplementation on serum lipid profile and oxidative stress in obese women with knee osteoarthritis: A double blind, randomized, placebo controlled study Haghighian MK, Rafraf M, Hemmati S, Haghravan S, Asghari-Jafarabadi M
Randomised Controlled Trial Knee Osteoarthritis Pomegranate Peel
The research was a randomized, double-blind placebo-controlled trial involving 66 obese women aged 38 to 60 years old with knee osteoarthritis. These participants were split into two groups, the intervention group and control group, each containing 33 members. The intervention group received pomegranate peel extract capsules (500 mg) twice daily for 8 weeks including standard drug therapy while the control group was given a placebo during the same period. All participants' fasting blood samples, anthropometric measurements, dietary intake data, and physical activity levels were collected both before the start and at the end of the trial.
Results analysis showed that pomegranate peel extract supplementation brought down levels of serum total cholesterol, triglyceride and an oxidative stress marker while enhancing levels of some antioxidant enzymes and the overall antioxidant capacity when compared to the control group. However, there were no noticeable alterations between the two groups in terms of low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and body mass index by the end of the experiment.
In the treatment of knee osteoarthritis, the acupuncture group had significant advantages over sham acupuncture or no-acupuncture groups in relieving pain and improving physical function.
2020 Journal of Acupuncture and Tuina Science Efficacy and safety of acupuncture for the treatment of knee osteoarthritis: a systematic review and meta-analysis Wang, Tt., Liu, Y., Ning, Zy. et al.
Systematic Review Knee Osteoarthritis
Eight databases were extensively searched up to March 2018. Randomized controlled trials (RCTs) comparing the efficacy of acupuncture with sham acupuncture or no acupuncture for knee osteoarthritis were included. The Cochrane Collaboration’s tool was used for assessing the risk of bias.
A total of 18 RCTs were included, involving a total of 3 522 participants. The results showed that acupuncture was superior to sham acupuncture in relieving pain and improving physical function. In comparison to the no-acupuncture group, the acupuncture group also showed significant advantages in relieving pain and improving physical function. Sensitivity analyses suggested that the results were robust, and Egger’s test found no potential publication bias.
Avocado-soybean unsaponifiables treatment is effective in reducing knee osteoarthritis symptoms without increasing adverse events, contrary to those with hip osteoarthritis.
2019 International Journal of Rheumatic Diseases Efficacy and safety of avocado‐soybean unsaponifiables for the treatment of hip and knee osteoarthritis: A systematic review and meta‐analysis of randomized placebo‐controlled trials Simental‐Mendía M, Sánchez‐García A, Acosta‐Olivo CA, Vilchez‐Cavazos F, Osuna‐Garate J, Peña‐Martínez VM, et al.
Systematic Review Avocado Avocado-Soybean Unsaponifiables Knee Osteoarthritis
To assess avocado-soybean unsaponifiables (ASU) effectiveness and safety, a systematic review and meta-analysis of randomized controlled trials involving patients with hip or knee osteoarthritis was conducted. Various scientific databases, including Medline, SCOPUS, Web of Science, and Google Scholar, were thoroughly searched for suitable trials. Selection criteria consisted of randomized placebo-controlled trials wherein the effect of orally administered ASU on knee or hip osteoarthritis symptoms were evaluated, primarily using the Lequesne index, visual analog scale, and joint space width.
The meta-analysis revealed a significant reduction in pain as assessed by the visual analog scale for those under Avocado-soybean unsaponifiables therapy, particularly for patients with knee osteoarthritis, indicated by a decrease in both the visual analogue scale and Lequesne index. However, no such significant effect was found for patients with hip osteoarthritis. In terms of safety, there were no significant differences in adverse events between patients receiving ASU and those given a placebo, confirming ASU's relative safety as a treatment option.
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