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

Abstract

BackgroundTraditional Chinese medicine (TCM) has been accepted as a complementary therapy for knee osteoarthritis. However, the efficacy and safety of the intervention were still conflicting and uncertain. Meanwhile, the quality of methodology and evidence in the field was unknown.ObjectiveTo summarize the characteristics and critically evaluate the quality of methodology, as well as the evidence of systematic reviews (SRs) on TCM for knee osteoarthritis.MethodsFive electronic databases were searched from inception to April 2016. The methodological quality of the included studies was assessed by AMSTAR and ROBIS. The quality of the evidence was determined using the GRADE approach.ResultsTen SRs were included. The conclusions suggest that TCM provides potential benefits for patients with knee osteoarthritis. These benefits include pain relief, functional improvement, and presence of few adverse events. Limitations of the methodological quality mainly included the lack of a-priori protocol or protocol registration and incomprehensive literature search. A list of excluded studies was also not provided. The overall quality of evidence in the SRs was poor, ranging from “very low” to “low,” mainly because of the serious risk of bias of original trials, inconsistencies, and imprecision in the outcomes.ConclusionsTCM generally appears to be effective for knee osteoarthritis treatment. However, the evidence is not robust enough because of the methodological flaws in SRs. Hence, these conclusions on available SRs should be treated with caution for clinical practice.

The knowledge and self-management educational needs of older adults with knee osteoarthritis: A qualitative study

“…Alternative medicine is popular among Asian older adults (56) as it is believed to be harmless [56,57]. The effectiveness of traditional remedies for knee pain, however, remains controversial [58][59][60][61][62]. The reluctance to accept painkillers appeared to lead to activity avoidance and functional limitations, which are the primary concerns of our older persons with KOA as well as being worried about not being able to observe religious rituals involving kneeing or sitting cross-legged.…”

Chrysin protects human osteoarthritis chondrocytes by inhibiting inflammatory mediator expression via HMGB1 suppression

“…Therefore, inhibiting chondrocyte apoptosis while promoting the maintenance of healthy chondrocytes represents a potential strategy for preventing cartilage degeneration (37,38). As TCMs are increasingly being used to treat OA (39), scientists have suggested that certain TCMs, particularly those used in combination formulas, may produce therapeutic effects in a synergistic manner. For example, XuanHuSuo powder (XHSP), a conventional herbal formulation developed in China, has been extensively used in OA treatment (40).…”

Abnormal expression of miR‑4784 in chondrocytes of osteoarthritis and associations with chondrocyte hyperplasia

“…OA is one of the most common types of chronic arthritis and seriously affects the quality of life in the elderly population ( 1 – 3 ). Major pathological features of OA include a series of biological and/or morphological changes, such as the degeneration of articular cartilage, hyperosteogeny and/or sclerosis ( 16 ).…”

“…The occurrence of OA is associated with many parameters, including genetic and immune factors; however, the exact pathogenesis remains unclear ( 3 ). The roles of various miRNAs in OA chondrocytes have been widely studied and have provided a novel research direction, which has helped to elucidate the pathogenesis of OA ( 13 ).…”

“…OA primarily affects the knee, hip and shoulder joints and the main symptoms include joint pain, swelling, joint deformity and limited mobility ( 2 ). The pathogenesis of OA is associated with aging, obesity, inflammation, immunity, genetics and many other factors ( 3 ). Cartilage degeneration is considered to be one of the primary pathological changes that cause OA, and this typically occurs due to metabolic disorders of extracellular matrix synthesis and degradation ( 4 ).…”