Acupotomy for knee osteoarthritis: Literature review and meta-analysis

PurposeAs a contemporary acupuncture technique combined with modern anatomy and biomechanics, acupotomy was widely used in clinical treatment of knee osteoarthritis (KOA). This article aims to evaluate the advantages and potential of acupotomy of KOA and to provide a reference for clinical decision-making.Patients and methodsWe conducted a comprehensive search across four databases of ancient Chinese classics to trace the historical development of acupotomy. Seven databases were searched for the meta-analysis of Randomized controlled trials (RCTs) that met the criteria to evaluate the clinical efficacy of acupotomy for KOA. Furthermore, we reviewed potential mechanisms underlying acupotomy treatment for KOA.ResultsAcupotomy originated from traditional acupuncture "Nine Needles" in China ancient books 2000 years ago, which had advantages in the treatment of muscle and bone related diseases. The results of the meta-analysis following PRISMA2020 showed that acupotomy was helpful for pain relief and improvement of knee mobility in KOA. Experiments showed that acupotomy may treat KOA through a variety of mechanisms, such as inhibiting the expression of inflammatory factors, promoting the proliferation of chondrocytes, affecting the degradation and synthesis of extracellular matrix, and adjusting the mechanical balance of the knee joint.DiscussionThe results of this meta-analysis suggest that the use of acupotomy can effectively improve the pain and increase the range of motion of KOA. The experimental data showed that acupotomy may play a therapeutic role by inhibiting inflammatory factors and changing the mechanical balance of the knee joint. All these can prove that acupotomy treatment has a good prospect.