January 13, 2014
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Acupuncture needle types equally effective with exercise for knee OA

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Puncturing and nonpuncturing acupuncture needles were equally effective along with exercise-based physical therapy as treatment for patients with knee osteoarthritis, according to study results.

Researchers conducted a randomized, double blind study of 214 patients in Philadelphia with knee osteoarthritis (OA; mean age, 60 years; 52% women, 66% African-American; mean BMI, 33 kg/m2). All patients had at least 6 months of knee pain with Kellgren-Lawrence scores (2 or 3) confirmed by X-ray. Patients received 12 weekly or semiweekly acupuncture treatments across 6 to 12 weeks after exercise-based physical therapy (EPT). Standard needles (105 patients) or nonskin-puncturing needles (109 controls) were used to perform acupuncture at nine points used in traditional Chinese “Bi” syndrome approach to knee pain.

Proportion of patients who improved by at least 36% in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores at 12 weeks was the primary outcome.

In the WOMAC response rate, there was no significant difference between standard needle (31.6%) and non-penetrating needle (30.3%) acupuncture. Both treatment groups displayed improvement from therapy (P=0.5). Most adverse events were mild, with 47 reported by the true acupuncture cohort compared with 31 in the control group (P=.08).

Using multivariate logistic regression, there was an association between a positive expectation from acupuncture and reported improvement (adjusted OR=2.14; 95% CI, 1.13-4.10), with no differences noted by patients’ race, sex or age.

“The patients enrolled in this study were significantly more obese than those in earlier studies, with preponderance in the African-American group,” the researchers reported.

“We did not find any differences in effect in the puncturing and nonpuncturing acupuncture therapy when used in conjunction with EPT,” the researchers concluded. “Our study also highlights that positive expectation may impact treatment outcomes.”

Disclosure: The researchers report no relevant financial disclosures.