ABSTRACT
Objective: To evaluate the efficacy and safety of acupuncture for the treatment of knee osteoarthritis and to provide evidence for its use in clinical practice. Methods: Eight databases were extensively searched up to March 2018. Randomized controlled trials (RCTs) comparing the efficacy of acupuncture with sham acupuncture or no acupuncture for knee osteoarthritis were included. Study selection, data extraction and quality assessment were independently conducted by two reviewers. The Cochrane Collaboration's tool was used for assessing the risk of bias. Results: A total of 18 RCTs were included, involving a total of 3522 participants. The results showed that acupuncture was superior to sham acupuncture in relieving pain (SMD=-0.34, 95％CI:-0.57 to -0.11, I2=85％, P=0.003) and improving physical function (SMD=-0.34, 95％CI: -0.57 to -0.11, I2=85％, P=0.003). In comparison to the no-acupuncture group, the acupuncture group also showed significant advantages in relieving pain (SMD=-0.79, 95％CI: -1.15 to -0.43, I2=87％, P<0.0001) and improving physical function (SMD=-0.75, 95％CI:-1.19 to -0.31, I2=91％, P=0.0008). Sensitivity analyses suggested that the results were robust, and Egger's test found no potential publication bias. Conclusion: In the treatment of knee osteoarthritis, the acupuncture group had significant advantages over sham acupuncture or no-acupuncture groups in relieving pain and improving physical function.