Acupuncture vs. Chinese Medicine for Knee Osteoarthritis: Systematic Review and Meta-Analysis.

BACKGROUND

This study aimed to systematically evaluate the clinical efficacy of acupuncture and external traditional Chinese medicine therapy, each combined with massage, for treating knee osteoarthritis.

METHODS

The meta-analysis followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and was registered with PROSPERO (CRD42024600977). A comprehensive search was conducted in databases including PubMed and Chinese Knowledge Infrastructure until September 2024. Inclusion criteria were: clinically confirmed knee osteoarthritis, interventions using acupuncture or traditional Chinese medicine with massage, existence of a control group, relevant outcome measures for pain relief and functional improvement, and peer-reviewed articles in English or Chinese. Exclusion criteria included studies with interventions over 60 days, surgical treatment cases, and studies without clear outcome measures. Analyses were performed using Review Manager 5.4 and Stata 16.0.

RESULTS

Twenty-two studies involving 2,216 patients met the criteria, with hospitalization durations of 10-56 days. Warm acupuncture combined with massage significantly reduced visual analog scale (VAS) scores and McMaster Universities Osteoarthritis Index (WOMAC) total scores while enhancing Lysholm index scores. Small needle knife therapy combined with massage also significantly decreased VAS scores. Additionally, external traditional Chinese medicine therapy with massage significantly reduced VAS scores, WOMAC total, stiffness, and pain scores, while Lysholm scores were increased compared to the massage group.

DISCUSSION: Acupuncture and traditional Chinese medicine therapy combined with massage are significantly more effective than massage alone for knee osteoarthritis. The limitations of our review include variability in massage techniques, session counts, and therapy durations among studies, inconsistent follow-up periods, and limited assessment of long-term effects.