Acupuncture for knee osteoarthritis--a randomised trial using a novel sham.

Full Abstract

BACKGROUND:
Evidence on the efficacy of acupuncture for reducing the pain and dysfunction of osteoarthritis is equivocal.

OBJECTIVE:
To determine whether acupuncture provides greater pain relief and improved function compared with sham acupuncture or education in patients with osteoarthritis of the knee.

DESIGN:
Randomised, controlled trial.

SETTING:
Two outpatient clinics (an integrative medicine facility and a rheumatology facility) located in academic teaching hospitals and one clinical trials facility.

PATIENTS:
570 patients with osteoarthritis of the knee (mean age [+/-SD], 65.5 +/- 8.4 years).

INTERVENTION:
23 true acupuncture sessions over 26 weeks. Controls received 6 two-hour sessions over 12 weeks or 23 sham acupuncture sessions over 26 weeks.

MEASUREMENTS:
Primary outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function scores at 8 and 26 weeks. Secondary outcomes were patient global assessment, 6-minute walk distance, and physical health scores of the 36-Item Short-Form Health Survey (SF-36).

RESULTS:
Participants in the true acupuncture group experienced greater improvement in WOMAC function scores than the sham acupuncture group at 8 weeks (mean difference, -2.9 [95% CI, -5.0 to -0.8]; P=0.01) but not in WOMAC pain score (mean difference, -0.5 [CI, -1.2 to 0.2]; P=0.18) or the patient global assessment (mean difference, 0.16 [CI, -0.02 to 0.34]; P> 0.2). At 26 weeks, the true acupuncture group experienced significantly greater improvement than the sham group in the WOMAC function score (mean difference, -2.5 [CI, -4.7 to -0.4]; P=0.01), WOMAC pain score (mean difference, -0.87 [CI, -1.58 to -0.16]; P=0.003), and patient global assessment (mean difference, 0.26 [CI, 0.07 to 0.45]; P=0.02).

LIMITATIONS:
At 26 weeks, 43% of the participants in the education group and 25% in each of the true and sham acupuncture groups were not available for analysis.

CONCLUSIONS:
Acupuncture seems to provide improvement in function and pain relief as an adjunctive therapy for osteoarthritis of the knee when compared with credible sham acupuncture and education control groups.

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Author information

Author/s: Manheimer, Eric (E); Lim, Byungmook (B); Lao, Lixing (L); Berman, Brian (B);

Affiliation: University of Maryland School of Medicine, Baltimore, Maryland 21207, USA. bberman(-atsign-)umm.edu

Journal and publication information

Publication Type: Journal Article

Journal: Acupuncture in medicine : journal of the British Medical Acupuncture Society (Acupunct Med), published in England. (Language: eng)

Reference: 2006-Dec; vol 24 Suppl (issue ) : pp S7-14

Dates: Created 2007/02/19; Completed 2007/06/06;

PMID: 17308513, status: PubMed-not-MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

ReprintIn: Ann Intern Med. 2004 Dec 21;141(12):901-10. (PMID: 15611487)

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