Evidence map›Paper›PMID 36593092›Full record

ArticleBritish journal of sports medicine2023

Comparative efficacy of exercise therapy and oral non-steroidal anti-inflammatory drugs and paracetamol for knee or hip osteoarthritis: a network meta-analysis of randomised controlled trials.

Qianlin Weng, Siew-Li Goh, Jing Wu, Monica S M Persson, Jie Wei, Aliya Sarmanova, Xiaoxiao Li, Michelle Hall, Michael Doherty, Ting Jiang and 3 more

Registry-linked trialOpen access · hybridAbstract readNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Article in British journal of sports medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06619080 (Ecoguided Genicular Nerve Block in Patients With Knee Osteoarthritis by Local Anesthetic or by Combination of Local Anesthetic and Corticoid), which is not on this map. Cited by 39 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
39citing papers in PubMed, 9 pooled it
17.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06619080 nacompletednot on this map

Ecoguided Genicular Nerve Block in Patients With Knee Osteoarthritis by Local Anesthetic or by Combination of Local Anesthetic and Corticoid: Placebo-Controlled Randomized Blind Clinical Trial

TypeinterventionalSponsorHospital Universitario Fundación AlcorcónRan2023 to 2024Enrolled102ConditionsOsteoarthritis, Knee/RehabilitationArmsGenicular nerve block with bupivacaine and corticosteroids, Genicular nerve block with bupivacaine, Genicular nerve block with saline
3 · Its place in the literature

Who cites it

39 citing papers in PubMed, 9 syntheses or guidelines pooled it, 73 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 4 institutions in 3 countries.

Qianlin Weng *Department of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Siew-Li Goh *Centre for Epidemiology and Evidence-Based Practice, University of Malaya, Kuala Lumpur, Malaysia.ORCID http://orcid.org/0000-0001-5898-1196
Jing WuHunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan, China.
Monica S M PerssonAcademic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK.
Jie WeiHunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan, China.
Aliya SarmanovaAcademic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK.
Xiaoxiao LiHunan Key Laboratory of Joint Degeneration and Injury, Changsha, Hunan, China.
Michelle HallPain Centre Versus Arthritis, University of Nottingham, Nottingham, UK.
Michael DohertyAcademic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK.
Ting JiangDepartment of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China.
Chao ZengDepartment of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China lei_guanghua@csu.edu.cn zengchao@csu.edu.cn weiya.zhang@nottingham.ac.uk.ORCID http://orcid.org/0000-0003-4889-5731
Guanghua LeiDepartment of Orthopaedics, Xiangya Hospital, Central South University, Changsha, Hunan, China lei_guanghua@csu.edu.cn zengchao@csu.edu.cn weiya.zhang@nottingham.ac.uk.ORCID http://orcid.org/0000-0003-2987-138X
Weiya ZhangAcademic Rheumatology, School of Medicine, University of Nottingham, Nottingham, UK lei_guanghua@csu.edu.cn zengchao@csu.edu.cn weiya.zhang@nottingham.ac.uk.
Central South University · CNUniversity of Nottingham · GBHunan University · CNUniversity of Malaya · MY

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveClinical guidelines recommend exercise as a core treatment for knee or hip osteoarthritis (OA). However, how its analgesic effect compares to analgesics, for example, oral non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol-the most commonly used analgesics for OA, remains unknown.

designNetwork meta-analysis. DATA SOURCES: PubMed, Embase, Scopus, Cochrane Library and Web of Science from database inception to January 2022. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomised controlled trials (RCTs) comparing exercise therapy with oral NSAIDs and paracetamol directly or indirectly in knee or hip OA.

resultsA total of n=152 RCTs (17 431 participants) were included. For pain relief, there was no difference between exercise and oral NSAIDs and paracetamol at or nearest to 4 (standardised mean difference (SMD)=-0.12, 95% credibility interval (CrI) -1.74 to 1.50; n=47 RCTs), 8 (SMD=0.22, 95% CrI -0.05 to 0.49; n=2 RCTs) and 24 weeks (SMD=0.17, 95% CrI -0.77 to 1.12; n=9 RCTs). Similarly, there was no difference between exercise and oral NSAIDs and paracetamol in functional improvement at or nearest to 4 (SMD=0.09, 95% CrI -1.69 to 1.85; n=40 RCTs), 8 (SMD=0.06, 95% CrI -0.20 to 0.33; n=2 RCTs) and 24 weeks (SMD=0.05, 95% CrI -1.15 to 1.24; n=9 RCTs).

conclusionsExercise has similar effects on pain and function to that of oral NSAIDs and paracetamol. Given its excellent safety profile, exercise should be given more prominence in clinical care, especially in older people with comorbidity or at higher risk of adverse events related to NSAIDs and paracetamol.CRD42019135166.

Indexed as

Osteoarthritis, HipOsteoarthritis, KneeAcetaminophenAgedAnalgesicsAnti-Inflammatory Agents, Non-SteroidalExercise TherapyHumansPainRandomized Controlled Trials as TopicAcetaminophenAnalgesicsAnti-Inflammatory Agents, Non-SteroidalExerciseMedicineMeta-analysisOsteoarthritis

Identifiers

PMID36593092
PMCPMC10423468
OpenAlexW4313453601

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.