Osteoarthritis of the Knee

More than 20 million Americans have osteoarthritis (OA) of the knee. This clinical entity is one of the most frequent causes of physical disability among adults (www.nih.gov/ news/pr/dec2004/nccam-20.htm). A recent study conducted at the University of North Carolina at Chapel Hill suggested that nearly 50% of US adults and nearly two-thirds of obese adults will develop painful knee OA by age 85 (uncnews.unc.edu September 2, 2008). According to the Forbes.com, OA of the knee is listed among the top 10 most expensive medical condition, costing 34 billion dollars. Berman et al. (1999) investigated the efficacy of acupuncture as an adjunctive therapy in elderly patients suffering from OA of the knee using a randomized crossover study design. These investigators found that patients randomized to acupuncture treatments had improvement on both McMaster University's OA index and Lequesne's indices at 4 and 8 weeks. The same research team then conducted a large-scale sham-controlled RCT that included 570 patients randomized to receive acupuncture treatment, sham treatment, or an educational intervention over a 6-month period (Berman et al. 2004). The research team found that patients in the acupuncture group experienced significantly greater improvement than the sham group in both McMaster University's OA index function and pain scores. A recent sham-controlled RCT published in Lancet randomized patients with OA of the knee to receive 8 weeks of acupuncture, sham, or waiting list control (Witt et al. 2005). The study found that patients in the acupuncture group experienced improved joint movement and significantly less pain. However, a follow-up at 1 year revealed no differences between the various study groups (Witt et al. 2005). At present, the available clinical data support the efficacy acupuncture as a short-term treatment of OA of the knee. Unfortunately, long-term benefits from acupuncture treatment have not been demonstrated to date.

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