Acupuncture in patients with osteoarthritis of the knee or hip: A randomized, controlled trial with an additional nonrandomized arm

Abstract

Objective. To investigate the effectiveness of acupuncture in addition to routine care, compared with routine care alone, in the treatment of patients with chronic pain due to osteoarthritis (OA) of the knee or hip.Methods. In a randomized, controlled trial, patients with chronic pain due to OA of the knee or hip were randomly allocated to undergo up to 15 sessions of acupuncture in a 3-month period or to a control group receiving no acupuncture. Another group of patients who did not consent to randomization underwent acupuncture treatment. All patients were allowed to receive usual medical care in addition to the study treatment. . Similarly, quality of life improvements were more pronounced in the acupuncture group versus the control group (P < 0.001). Treatment success was maintained through 6 months. The changes in outcome in nonrandomized patients were comparable with those in randomized patients who received acupuncture.Conclusion. These results indicate that acupuncture plus routine care is associated with marked clinical improvement in patients with chronic OA-associated pain of the knee or hip.

Meta-analysis: Acupuncture for Osteoarthritis of the Knee

“…For all waiting list-controlled trials, patients on the waiting lists were allowed to receive the current level of oral NSAID or analgesic therapy. ‡ For the 5 RCTs that used a waiting list control group (36,37,41,47,48), we excluded all outcome measurements after patients on the waiting list began acupuncture. Sangdee and colleagues' trial (44) also had a measurement time point at 9 wk for responders only.…”

“…By having to wait for a treatment that they believe is effective (48), patients waiting for acupuncture may be disappointed by the delay, which may influence their ratings of subjective outcomes while waiting. However, despite the limitations of the usual care and waiting list comparator designs, these designs may still best approximate the average likely response to acupuncture in clinical practice, in which treatment effects and placebo factors, expectation effects, and patient preferences may operate (52).…”

“…All studies but 1 (42) were published in English. We obtained unpublished data from 8 authors (outcome data [43,[45][46][47][48] and methodological information [35,36,41,46]). …”

“…Three (36,43,46) were funded by government grants, 1 (44) by a university, and 3 (45,47,48) by health insurance companies.…”

Warm needle acupuncture vs. needle acupuncture for osteoarthritis of the knee: A pilot study protocol

“…Other elements of the inclusion criteria are designed to be broadly in line with previous high quality studies of acupuncture for osteoarthritis of the knee [14,16] …”