Acupuncture for Knee Osteoarthritis: A Systematic Review of Randomized Clinical Trials with Meta-Analyses and Trial Sequential Analyses

Tian H, Huang L, Sun M, Xu G, He J, Zhou Z, Huang F, Liu Y, Liang F · BioMed Research International · 2022 April 21

DOI 10.1155/2022/6561633

Objective

Knee osteoarthritis (KOA) can cause chronic pain and seriously affect the quality of patient lives. The continued emergence of high-quality RCTS requires us to update the quality of evidence. This study aims to evaluate the efficacy of acupuncture for KOA patients and calculate the required information size (RIS) to determine whether further clinical studies are required.

Conclusions

Acupuncture has beneficial effect on pain relief and improves function activities, and this treatment can be recommended as a beneficial alternative therapy in patients with KOA, particularly for chronic patients and those currently undergoing long-term pain and help them increasing quality of life.

Critical Appraisal

Published research can offer valuable insights, but a paper’s conclusions may go beyond what its results support. Critical appraisal examines the methods, findings and limitations to clarify what can reasonably be concluded—and what remains uncertain.

This article has not yet been critically appraised by the Research Hub.

Learn more about Critical Appraisal

Insights

Acupuncture can reduce pain and improve functional activities in patients with knee osteoarthritis, proving particularly beneficial for chronic sufferers and enhancing their quality of life.

This study amassed randomized controlled trials from various databases including PubMed, Embase, and others to assess the effectiveness of acupuncture in alleviating the symptoms of knee osteoarthritis. The researchers conducted a meta-analysis using the Cochrane systematic review method by integrating Review Manager 5.4 and TSA 0.9.5.10 beta software, in conjunction with the GRADE approach for quality assessment of the evidence. They also implemented a trial sequential analysis to manage random errors and calculate the required information size. The meta-analysis included eleven randomized controlled trials involving 2484 patients. The results indicate a positive effect of acupuncture on reducing pain and enhancing patient functionality. Conversely, stiffness symptoms were not significantly alleviated by acupuncture. Moreover, the analysis demonstrated no substantial difference between the effectiveness of acupuncture and sham procedures in improving the psychological aspects of patients' quality of life. Furthermore, physical health improvement, as measured by SF-36 or SF-12, was not significantly different between groups receiving real or sham acupuncture. The trial sequential analysis graphs showed cumulative Z-curves crossing the traditional statistical level favoring acupuncture, highlighting its potential usefulness. Therefore, acupuncture shows promise as an alternative therapy for patients with knee osteoarthritis.