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Acupcunture
Research
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| Paper
Title |
Acupuncture in
patients with osteoarthritis of the knee: a randomised trial
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| Author(s) |
C Witt,
B Brinkhaus, S Jena,
K Linde, A Streng,
S Wagenpfeil, J Hummelsberger,
HU Walther, D Melchart
and SN Willich |
| Journal
Reference |
The
Lancet 2005; 366:136-143 |
| Background |
Acupuncture
is widely used by patients with chronic pain although there is little
evidence of its effectiveness. We investigated the efficacy of acupuncture
compared with minimal acupuncture and with no acupuncture in patients with
osteoarthritis of the knee. |
| Methods |
Patients
with chronic osteoarthritis of the knee (Kellgren grade ≤2) were
randomly assigned to acupuncture (n=150), minimal acupuncture (superficial
needling at non-acupuncture points; n=76), or a waiting list control
(n=74). Specialised physicians, in 28 outpatient centres, administered
acupuncture and minimal acupuncture in 12 sessions over 8 weeks. Patients
completed standard questionnaires at baseline and after 8 weeks, 26 weeks,
and 52 weeks. The primary outcome was the Western Ontario and McMaster
Universities Osteoarthritis (WOMAC) index at the end of week 8 (adjusted
for baseline score). All main analyses were by intention to treat. |
| Results |
294
patients were enrolled from March 6, 2002, to January 17, 2003; eight
patients were lost to follow-up after randomisation, but were included in
the final analysis. The mean baseline-adjusted WOMAC index at week 8 was
26·9 (SE 1·4) in the acupuncture group, 35·8 (1·9) in the minimal
acupuncture group, and 49·6 (2·0) in the waiting list group (treatment
difference acupuncture vs minimal acupuncture −8·8, [95% CI
−13·5 to −4·2], p=0·0002; acupuncture vs waiting
list −22·7 [−27·5 to −17·9], p<0·0001). After 52
weeks the difference between the acupuncture and minimal acupuncture
groups was no longer significant (p=0·08). |
Author
Interpretation |
After
8 weeks of treatment, pain and joint function are improved more with
acupuncture than with minimal acupuncture or no acupuncture in patients
with osteoarthritis of the knee. However, this benefit decreases over
time. |
| Clinical
Significance |
After
8 weeks, significant benefits on pain and function were noted. The
fact that benefits decrease over time does not discount the fact that over
the short term benefits are found. The benefits in pain relief and
function offer patients to initiate physical activity programs (which are
also important in minimizing symptoms associated with
osteoarthritis). Additionally, low rates of side effects associated
with acupuncture make it a reasonable option to consider for supportive
therapy along with physical rehabilitation and pharmacological
interventions when indicated. |
| NOTE:
The clinical significance review is the opinion of Dr Ken Mueller based
upon the information available at the time of posting. Unauthorized
use of that section on clinical significance is prohibited by Canadian
Copyright. The above research abstract is based on information
posted on www.thelancet.com.
For further information, please refer to the original article utilizing
the publication information provided. January 2, 2005 |
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