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The Effect of Acupuncture and Physiotherapy on Patients with Knee Osteoarthritis: A Randomized Controlled Study.

BACKGROUND
Osteoarthritis is the most prevalent form of joint disease, and the most common location is the knee.


OBJECTIVES
The aim of this study was to determine the effect of acupuncture treatment and physiotherapy on pain, physical function, and quality of life (QOL) in patients with knee osteoarthritis (KOA).


STUDY DESIGN
This study was a prospective, randomized, controlled clinical trial.


SETTINGS
The research took place in the interventional pain unit of a tertiary center in a university hospital.


METHODS
One hundred patients with KOA were randomly divided into the acupuncture group and the physiotherapy group. Both treatments were given in 12 sessions over 6 weeks. Thirteen acupuncture points were selected for the knee. Local points were GB34, SP10, SP9, ST36, ST35, ST34, EX-LE2, EX-LE5, EXLE4, and distal (distant) points were defined as KI3, SP6, LI4, and ST41. The Visual Analog Scale (VAS) was used to measure pain intensity. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the 36-Item Short Form Health Survey (SF-36) were used to determine functional status and health-related QOL, respectively. All patients were evaluated at baseline, after the last treatment, and at the 12-week follow-up period.


RESULTS
There was no statistically significant difference between the acupuncture group and physiotherapy group in terms of pain, total WOMAC, and SF-36 levels at baseline, after treatment, and at the 12th week after treatment (P > 0.05). Both treatments significantly improved functional status (acupuncture, from 63.8 ± 20.81 to 53.72 ± 19.43; and physiotherapy, from 59.04 ± 21.49 to 52.28 ± 19.54; P < 0.05) and decreased the level of pain assessed by VAS (acupuncture, from 8.32 ± 1.61 to 5.54 ± 2.34; and physiotherapy, from 7.86 ± 1.9 to 5.68 ± 2.42; P < 0.05) at the 12-week follow-up of the study. There was no adverse advent related to therapeutic methods.


LIMITATIONS
Sham or placebo control groups are lacking in this study.


CONCLUSIONS
The acupuncture and physiotherapy performed twice weekly for 6 weeks have similar effects with regard to pain, functional status, and QOL. There were no significant differences between the acupuncture and physiotherapy groups in relief of pain, improved functional status, and QOL in the treatment of KOA. Both acupuncture and physiotherapy treatments were found to yield significantly superior results when compared with baseline values.