Electroacupuncture for knee osteoarthritis: a multicentre randomised controlled trial assessing symptomatic and...

Area of Science:

• Orthopedics and Sports Medicine
• Rheumatology
• Integrative and Complementary Medicine

Background:

• Limited high-quality evidence exists for electroacupuncture (EA) in knee osteoarthritis (KOA), with its effects on structural progression unknown.
• Investigated whether EA offers structural benefits beyond symptomatic relief in KOA patients.

Purpose of the Study:

• To evaluate the efficacy of electroacupuncture (EA) compared to sham acupuncture (SA) in treating knee osteoarthritis (KOA).
• To assess the impact of EA on both symptomatic relief and potential structural changes in KOA.

Main Methods:

• A multicentre, randomized, parallel-group trial involving 480 participants with KOA, assigned to EA or SA for six weeks.
• Primary outcome: change in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) global score at week 6.
• Secondary outcomes included WOMAC subscales, VAS, Lequesne index, Lysholm score, 6MWT, and exploratory AI-based MRI measures.

Main Results:

• EA group showed significantly greater improvement in WOMAC global score compared to SA at week 6 (p < 0.001), exceeding minimal clinically important improvement.
• Consistent benefits observed across all secondary symptomatic outcomes, including pain, stiffness, function, and mobility.
• Exploratory MRI indicated potential reductions in synovial inflammation and cartilage loss with EA, though effect sizes varied.

Conclusions:

• A six-week course of electroacupuncture (EA) provides substantial and durable symptomatic relief for knee osteoarthritis (KOA) patients.
• Exploratory findings suggest EA may possess anti-inflammatory and cartilage-protective properties.
• Further trials specifically powered for imaging endpoints are needed to confirm the structural effects of EA in KOA.