SynthesisBMJ evidence-based medicine2024
Clinical effect and contributing factors of acupuncture for knee osteoarthritis: a systematic review and pairwise and exploratory network meta-analysis.
Synthesis in BMJ evidence-based medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 4 of them syntheses that pooled 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.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Clinical Effects of Acupuncture in the Treatment of Knee Osteoarthritis: An Umbrella Review of Level I Evidence.Journal of evidence-based medicine · 2026Pooled it
- Global research trends and insights in acupuncture randomized controlled trials: a bibliometric analysis.Frontiers in medicine · 2026Pooled it
- Mechanisms of active metabolites from traditional Chinese medicine in osteoarthritis: a critical review.Frontiers in pharmacology · 2026Pooled it
- Research trends and hotspots of acupuncture for knee osteoarthritis from 2004 to 2024: a bibliometric analysis.Frontiers in medicine · 2025Pooled it
- Myofascial Trigger Point-Augmented Acupuncture vs Conventional Acupuncture for Early- to Mid-Stage Knee Osteoarthritis: A Randomized Clinical Trial.Journal of pain research · 2026Trial
- Shuci method of electroacupuncture improves self-perception and quality of life in patients with knee osteoarthritis: a multicenter randomized controlled trial.Frontiers in medicine · 2026Trial
- Acupuncture suppresses the endoplasmic reticulum stress-c-Jun N-terminal kinase pathway to inhibit chondrocyte apoptosis and attenuate knee osteoarthritis.Cell stress & chaperones · 2026Article
- Comparative Outcomes of Electroacupuncture, Warm Acupuncture, and Their Combination in Patients Receiving Standard Treatment for Knee Osteoarthritis: A Retrospective Cohort Study.International journal of rheumatic diseases · 2026Article
- Osteoarthritis: Epidemiology, Diagnosis, and Treatment.MedComm · 2026Review
- Evolving Strategies for Knee Osteoarthritis: A Narrative Review of Integrated Rehabilitation, Pharmacologic, and Joint-Preserving Interventions.Medical science monitor : international medical journal of experimental and clinical research · 2026Review
- Acupuncture Prescription Based on Thermal-Sensitized Acupoints for the Treatment of Knee Osteoarthritis: Protocol for a Randomized Controlled Pilot Trial.JMIR research protocols · 2026Article
- Nutritional Interventions in Osteoarthritis: Mechanisms, Clinical Evidence, and Translational Opportunities.Nutrients · 2026Review
- Non-Pharmacological Complementary and Alternative Therapies for Knee Osteoarthritis: A Scoping Review of Randomized Controlled Trials.Journal of pain research · 2026Review
- Electroacupuncture attenuates synovitis in knee osteoarthritis and is associated with modulation of the protein S-TAM (Axl/MerTK)-Rac1 signaling axis.Frontiers in immunology · 2026Article
- Potential mechanisms of acupuncture in regulating neuroinflammation and central sensitization in chronic pain: a narrative review of preclinical, clinical, and translational evidence.American journal of translational research · 2026Review
- Pain Modulation, Inflammation-Regulatory Mechanisms, and Translational Boundaries of Evidence for Acupuncture-Related Therapies in Knee Osteoarthritis: A Structured Narrative Review.Journal of pain research · 2026Review
- Evaluating the Effect of Electroacupuncture in Knee Osteoarthritis: Protocol for a Multicenter Randomized Controlled Trial.Journal of pain research · 2026Article
- Sympathetic regulation of bone homeostasis and remodeling: molecular mechanisms, pathophysiological roles, and therapeutic implications.Frontiers in immunology · 2026Review
- Different Acupuncture Therapies for Postoperative Residual Pain Following PKP/PVP for Osteoporotic Vertebral Compression Fractures: A Protocol for a Systematic Review and Bayesian Network Meta-Analysis.Journal of pain research · 2026Review
- Precise diagnosis and management of non-traumatic radial nerve palsy attributed to multiple rare etiologies: case study and literature review.Frontiers in medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study aims to evaluate (1) the effect and safety of acupuncture in patients with knee osteoarthritis (KOA) and explore (2) whether the effect of acupuncture differed according to acupuncture type, acupuncture dose and follow-up time.
designSystematic review and pairwise and exploratory network meta-analysis.
settingPubMed, Embase, Cochrane Central Register of Controlled Trials, Web of Science, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals and Wanfang from inception to 13 November 2023.
participantsRandomised controlled trials comparing acupuncture with sham acupuncture, non-steroidal anti-inflammatory drugs (NSAIDs), usual care or waiting list groups, intra-articular (IA) injection and blank groups in patients with KOA.
interventionsEligible interventions included manual acupuncture (MA) and electroacupuncture (EA). MAIN OUTCOMES MEASURES: The primary outcome was pain intensity at the end of treatment.
results80 trials (9933 participants) were included. Very low certainty evidence suggested that acupuncture may reduce pain intensity compared with sham acupuncture (standardised mean difference, SMD -0.74, 95% CI -1.08 to -0.39, corresponded to a difference in Visual Analogue Scale of -18.50 mm, -27.00 to -9.75), NSAIDs (SMD -0.86 -1.26 to -0.46, corresponded to -21.50 mm, -31.50 to -11.50), usual care or waiting list groups (SMD -1.01, -1.47 to -0.54, corresponded to -25.25 mm, -36.75 to -13.50) and blank groups (SMD -1.65, -1.99 to -1.32, corresponded to -41.25 mm, -49.75 to -33.00), but not IA injection. Similar results were also found in other outcomes. For most of the subgroup analyses, acupuncture type, acupuncture dose and follow-up time did not show a significant relative effect. Only when compared with NSAIDs, a higher dose of acupuncture may provide greater pain relief (interaction p<0.001). The network meta-analysis revealed that electroacupuncture (SMD -0.75, 95% CI -1.34 to -0.17) had a greater effect on pain relief in patients with KOA compared with manual acupuncture.
conclusionsThe findings suggest that acupuncture may provide clinically important effects in reducing pain and improving physical function in patients with KOA, but the certainty of evidence was very low. Electroacupuncture and higher dose of acupuncture probably are two potential contributing factors. PROSPERO REGISTRATION NUMBER: CRD42021232177.
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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.