Laser Acupuncture for Patients with Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Randomized Placebo-Controlled Trials.

Zhonggai Chen,Lidong Wu,Safwat Adel Abdo Moqbel,Chiyuan Ma,Yuzhe He,Langhai Xu,Zhipeng Wu,Kai Xu

doi:10.1155/2019/6703828

Abstract

Objectives To provide updated evidence from randomized controlled trials (RCTs) on the effectiveness of laser acupuncture for patients with knee osteoarthritis (KOA). Methods A literature search in 9 databases was conducted from their inception through February 2019. Randomized controlled trials (RCTs) written in English that compared active laser acupuncture with placebo in KOA patients were included. Two authors independently extracted data from these trials. Meta-analysis software was used to analyze the data. Included studies were assessed in terms of the follow-up period, the methodological quality, and appropriateness of their technical features. Results Of 357 studies, seven RCTs (totaling 395 patients) met the inclusion criteria. The short-term outcomes showed that laser acupuncture offered significant pain relief over placebo when assessed by the 100 mm visual analog scale (VAS) pain score (p = 0.02), while there was no significant difference between laser acupuncture and placebo based on Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain score (p = 0.25). For subgroup analysis, laser acupuncture had superiority over placebo in terms of both VAS and WOMAC pain scores in the appropriate technical features subgroup and the excellent methodological quality subgroup. But the effect of laser acupuncture on pain relief was not maintained in terms of either VAS (p = 0.19) or WOMAC pain score (p = 0.60). The pooled effect showed no significant difference between laser acupuncture and placebo at either time point according to WOMAC function scale, WOMAC stiffness scale, and quality of life outcome. Conclusions Our findings indicate that laser acupuncture can effectively reduce knee pain for patients with KOA at short term when appropriate technical features are applied, but the effect likely fades away during the subsequent follow-up period.

Highlights

Osteoarthritis (OA) is one of the most common degenerative diseases that cause chronic pain and disability in the elderly [1], with knee OA ranked 11th among 291 diseases for disability globally [2]
Others: KC; MTS; Laser acupuncture was found to be effective only in reducing periarticular swelling when compared with placebo baseline assessment
Subgroup analysis performed in this study showed that studies with appropriate technical features or higher methodological quality tended to get a more significant result, with a favorable effect of laser acupuncture on both short-term and long-term pain outcomes, the effect faded away over time

Summary

Introduction

Osteoarthritis (OA) is one of the most common degenerative diseases that cause chronic pain and disability in the elderly [1], with knee OA ranked 11th among 291 diseases for disability globally [2]. Knee OA cannot be cured so far and will likely worsen over time [3], and increases in life expectancy and ageing populations are expected to exacerbate the healthcare burden. E management for knee OA mainly aims to relieve joint pain, improve joint function, and enhance the quality of life [4, 5]. Available modalities of management for knee OA include nonpharmacological, pharmacological, and surgical treatments [6]. It is widely recommended that the nonpharmacological intervention should be the first line of treatment for people with knee OA [6,7,8]. It is widely recommended that the nonpharmacological intervention should be the first line of treatment for people with knee OA [6,7,8]. ere are many modalities of this intervention, such as exercise, education, weight loss, manual therapy, acupuncture, bracing and taping, orthoses, balneotherapies, electrotherapies, and other complementary therapies [1, 8].

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