title: Effectiveness of acupuncture as adjunctive therapy in osteoarthritis of the knee: a randomized, controlled trial.
abstract: BACKGROUND
  Evidence on the efficacy of acupuncture for reducing the pain and dysfunction of osteoarthritis is equivocal.
  
  
  OBJECTIVE
  To determine whether acupuncture provides greater pain relief and improved function compared with sham acupuncture or education in patients with osteoarthritis of the knee.
  
  
  METHODS
  Randomized, controlled trial.
  
  
  METHODS
  Two outpatient clinics (an integrative medicine facility and a rheumatology facility) located in academic teaching hospitals and 1 clinical trials facility.
  
  
  METHODS
  570 patients with osteoarthritis of the knee (mean age [+/-SD], 65.5 +/- 8.4 years).
  
  
  METHODS
  23 true acupuncture sessions over 26 weeks. Controls received 6 two-hour sessions over 12 weeks or 23 sham acupuncture sessions over 26 weeks.
  
  
  METHODS
  Primary outcomes were changes in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function scores at 8 and 26 weeks. Secondary outcomes were patient global assessment, 6-minute walk distance, and physical health scores of the 36-Item Short-Form Health Survey (SF-36).
  
  
  RESULTS
  Participants in the true acupuncture group experienced greater improvement in WOMAC function scores than the sham acupuncture group at 8 weeks (mean difference, -2.9 [95% CI, -5.0 to -0.8]; P = 0.01) but not in WOMAC pain score (mean difference, -0.5 [CI, -1.2 to 0.2]; P = 0.18) or the patient global assessment (mean difference, 0.16 [CI, -0.02 to 0.34]; P > 0.2). At 26 weeks, the true acupuncture group experienced significantly greater improvement than the sham group in the WOMAC function score (mean difference, -2.5 [CI, -4.7 to -0.4]; P = 0.01), WOMAC pain score (mean difference, -0.87 [CI, -1.58 to -0.16];P = 0.003), and patient global assessment (mean difference, 0.26 [CI, 0.07 to 0.45]; P = 0.02).
  
  
  CONCLUSIONS
  At 26 weeks, 43% of the participants in the education group and 25% in each of the true and sham acupuncture groups were not available for analysis.
  
  
  CONCLUSIONS
  Acupuncture seems to provide improvement in function and pain relief as an adjunctive therapy for osteoarthritis of the knee when compared with credible sham acupuncture and education control groups.
authors.affiliation: University of Maryland School of Medicine, Baltimore, Maryland 21207, USA.
authors.forename: Brian M
authors.initials: BM
authors.lastname: Berman
authors.forename: Lixing
authors.initials: L
authors.lastname: Lao
authors.forename: Patricia
authors.initials: P
authors.lastname: Langenberg
authors.forename: Wen Lin
authors.initials: WL
authors.lastname: Lee
authors.forename: Adele M K
authors.initials: AM
authors.lastname: Gilpin
authors.forename: Marc C
authors.initials: MC
authors.lastname: Hochberg
mesh_terms: D015670:Acupuncture Therapy; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D010146:Pain / Q000209:etiology; D059408:Pain Management; D010147:Pain Measurement; D020127:Recovery of Function / Q000502:physiology; D016896:Treatment Outcome