Efficacy of periosteal stimulation therapy for the treatment of osteoarthritis-associated chronic knee pain: an initial controlled clinical trial.
OBJECTIVE
To examine the efficacy of periosteal stimulation therapy (PST, osteopuncture) for the treatment of chronic pain associated with advanced knee osteoarthritis.


METHODS
Randomized, controlled clinical trial.


METHODS
Outpatient pain clinic.


METHODS
Eighty-eight community-dwelling older adults with moderate knee pain or greater for 3 months or longer and Kellgren-Lawrence (K-L) grade 2 through 4 radiographic severity (80% had K-L 4).


METHODS
Participants were randomized to receive PST or control PST once a week for 6 weeks.


METHODS
Pain severity and self-reported function (Western Ontario and McMasters University Osteoarthritis Index (WOMAC)) and physical performance (Short Physical Performance Battery (SPPB)) were assessed at baseline, after the last PST session (post), and 3 months later (follow-up). Pain severity was also assessed monthly using the multidimensional pain inventory short form.


RESULTS
Pain was reduced significantly more in the PST group than in the control PST group at post (P=.003; mean WOMAC pain subscale baseline 9.4 vs 6.4) and 1 month later (P<.001), but by 2 months, pain levels had regressed to pre-intervention levels. The group-by-time interaction for the WOMAC function scale was significant at post (P=.04) but not at follow-up (P=.63). No significant group differences were found for the SPPB. Neither analgesic use nor global improvement differed between groups. There were four treatment dropouts.


CONCLUSIONS
PST affords short-term modest pain reduction for older adults with advanced knee OA. Future research should test the effectiveness of booster treatments in sustaining analgesic benefits and of combining PST with therapeutic exercise in ameliorating disability risk.
Weiner
Debra K
DK
Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania 15206, USA. dweiner@pitt.edu
Rudy
Thomas E
TE
Morone
Natalia
N
Glick
Ronald
R
Kwoh
C Kent
CK
D015670:Acupuncture Therapy / Q000379:methods*; D000368:Aged; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D020370:Osteoarthritis, Knee / Q000145:classification / Q000628:therapy*; D059408:Pain Management; D010147:Pain Measurement; D012720:Severity of Illness Index