Acupuncture for chronic knee pain: a randomized clinical trial.

Hinman, Rana S., McCrory, Paul, Pirotta, Marie, Relf, Ian, Forbes, Andrew, Crossley, Kay M., Williamson, Elizabeth, Kyriakides, Mary, Novy, Kitty, Metcalf, Ben R., Harris, Anthony, Reddy, Prasuna, Conaghan, Philip G. and Bennell, Kim L. (2014) Acupuncture for chronic knee pain: a randomized clinical trial.. JAMA: The Journal of the American Medical Association, 312 13: 1313-1322. doi:10.1001/jama.2014.12660

Author Hinman, Rana S.
McCrory, Paul
Pirotta, Marie
Relf, Ian
Forbes, Andrew
Crossley, Kay M.
Williamson, Elizabeth
Kyriakides, Mary
Novy, Kitty
Metcalf, Ben R.
Harris, Anthony
Reddy, Prasuna
Conaghan, Philip G.
Bennell, Kim L.
Title Acupuncture for chronic knee pain: a randomized clinical trial.
Journal name JAMA: The Journal of the American Medical Association   Check publisher's open access policy
ISSN 1538-3598
Publication date 2014-10-01
Year available 2014
Sub-type Article (original research)
DOI 10.1001/jama.2014.12660
Open Access Status
Volume 312
Issue 13
Start page 1313
End page 1322
Total pages 10
Place of publication Chicago, United States
Publisher American Medical Association
Collection year 2015
Language eng
Formatted abstract
Importance There is debate about benefits of acupuncture for knee pain.

Objective To determine the efficacy of laser and needle acupuncture for chronic knee pain.

Design, Setting, and Participants Zelen-design clinical trial (randomization occurred before informed consent), in Victoria, Australia (February 2010-December 2012). Community volunteers (282 patients aged ≥50 years with chronic knee pain) were treated by family physician acupuncturists.

Interventions No acupuncture (control group, n = 71) and needle (n = 70), laser (n = 71), and sham laser (n = 70) acupuncture. Treatments were delivered for 12 weeks. Participants and acupuncturists were blinded to laser and sham laser acupuncture. Control participants were unaware of the trial.

Main Outcomes and Measures
Primary outcomes were average knee pain (numeric rating scale, 0 [no pain] to 10 [worst pain possible]; minimal clinically important difference [MCID], 1.8 units) and physical function (Western Ontario and McMaster Universities Osteoarthritis Index, 0 [no difficulty] to 68 [extreme difficulty]; MCID, 6 units) at 12 weeks. Secondary outcomes included other pain and function measures, quality of life, global change, and 1-year follow-up. Analyses were by intention-to-treat using multiple imputation for missing outcome data.

Results At 12 weeks and 1 year, 26 (9%) and 50 (18%) participants were lost to follow-up, respectively. Analyses showed neither needle nor laser acupuncture significantly improved pain (mean difference; −0.4 units; 95% CI, −1.2 to 0.4, and −0.1; 95% CI, −0.9 to 0.7, respectively) or function (−1.7; 95% CI, −6.1 to 2.6, and 0.5; 95% CI, −3.4 to 4.4, respectively) compared with sham at 12 weeks. Compared with control, needle and laser acupuncture resulted in modest improvements in pain (−1.1; 95% CI, −1.8 to −0.4, and −0.8; 95% CI, −1.5 to −0.1, respectively) at 12 weeks, but not at 1 year. Needle acupuncture resulted in modest improvement in function compared with control at 12 weeks (−3.9; 95% CI, −7.7 to −0.2) but was not significantly different from sham (−1.7; 95% CI, −6.1 to 2.6) and was not maintained at 1 year. There were no differences for most secondary outcomes and no serious adverse events.

Conclusions and Relevance In patients older than 50 years with moderate or severe chronic knee pain, neither laser nor needle acupuncture conferred benefit over sham for pain or function. Our findings do not support acupuncture for these patients.
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Health and Rehabilitation Sciences Publications
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Citation counts: TR Web of Science Citation Count  Cited 32 times in Thomson Reuters Web of Science Article | Citations
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