Effectiveness and safety of probiotics in treating knee osteoarthritis: an updated systematic review and meta-analysis of randomized controlled trials.

Knee osteoarthritis (KOA) is a prevalent degenerative joint disease, and gut microbiota dysbiosis in its pathogenesis is a research hotspot. This study performed a traditional meta-analysis to systematically evaluate probiotics' efficacy (for KOA symptoms, strain-specific superiority) and safety, using RCT data from Chinese and English databases. Stata 17.0 and RevMan 5.4 analyzed outcomes including patient-reported pain (Visual Analog Scale (VAS), WOMAC pain), joint stiffness, function limitation, serum High-sensitivity C-reactive protein (hs-CRP), and safety. Probiotics showed no significant adverse event differences vs. placebo, with no serious safety issues. Results suggest probiotics have potential for KOA, especially Saccharomyces boulardii and LatiLactobacillus sakei LB-P12. However, small sample sizes and limited studies weaken evidence; further research is needed.