Traditional Chinese medicine for knee osteoarthritis: An overview of systematic review

Yang M, Jiang L, Wang Q, Chen H, Xu G · PLOS One · 2017 December 21

Objective

To summarize the characteristics and critically evaluate the quality of methodology, as well as the evidence of systematic reviews (SRs) on TCM for knee osteoarthritis.

Conclusions

In summary, published systematic reviews (SRs) described the potential benefits of TCM for patients with knee osteoarthritis (OA) as follows: pain relief, functional improvement, and presence of few adverse events.

Critical Appraisal

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Insights

Traditional Chinese Medicine offers potential benefits like pain relief and functional improvement for knee osteoarthritis with few adverse events.

Five electronic databases were searched up until April 2016 to study the efficacy and safety of Traditional Chinese Medicine (TCM) for treating knee osteoarthritis. The methodological quality of the included studies was evaluated using the Assessment of Multiple Systematic Reviews (AMSTAR) and the Risk of Bias in Systematic reviews (ROBIS) tools. The quality of evidence was determined using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. The findings indicate that TCM potentially benefits patients with knee osteoarthritis through pain relief, functional improvement, and few adverse effects. However, deficiencies were found in the methodological quality of the reviews, such as the absence of an a-priori protocol or protocol registration, and an incomplete literature search. Furthermore, none of the studies offered a list of excluded studies. Overall, the quality of evidence in the systematic reviews was deemed poor, ranging from 'very low' to 'low'. This shortcoming was primarily due to a substantial risk of bias in the original trials, inconsistencies, and imprecision in the outcomes. Though TCM generally appears to be effective for knee osteoarthritis treatment, the evidence is not strong enough due to methodological flaws. Therefore, these findings should be approached cautiously in a clinical setting.