Superficial Needling Acupuncture vs Sham Acupuncture for Knee Osteoarthritis: A Randomized Controlled Trial

Background: Acupuncture has been an alternative approach for pain management, but trial evidence is conflicting. Methods: Eighty-six patients with knee osteoarthritis were randomly assigned in a 1:1 ratio from June 14, 2017, to January 20, 2019, to receive either superficial needling acupuncture treatment or sham acupuncture for 10 sessions over a 4-week treatment period, followed by a 6-week follow-up period. The primary outcome was the change of pain intensity at week 4 measured using a 100-mm visual analogue scale. Secondary outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index and 36-Item Short Form Health Survey. Results: At the end of the 4-week treatment period, mean changes in the visual analogue scale were −30.8 (95% confidence interval [CI], −38.2 to −23.0; p <.001) in the acupuncture group and −26.7 (95% CI, −34.4 to −18.8; P <.001) in the sham group. The difference between the acupuncture group and the sham group was −4.1 (95% CI, −14.4 to 6.2; P = 0.431). At week 10, the difference between the groups was −2.2 (95% CI, −13.1 to 8.8; P =0.699). There was no statistically significant difference in Western Ontario and McMaster Universities Osteoarthritis Index subscores (pain, stiffness, and physical function) and 36-Item Short Form Health Survey-related outcomes across groups from weeks 2 to 10. The incidence of treatment-related adverse events was 4.4% in the acupuncture group and 0.8% in the sham acupuncture group. All adverse events were classified as mild. Conclusion: Acupuncture for 4 weeks is not superior to non-penetrating sham acupuncture. The current study cannot confirm that superficial acupuncture has efficacy for the treatment of knee osteoarthritis.