Systematic evaluation and meta-analysis of extracorporeal shock wave therapy in the treatment of knee osteoarthritis / 中国组织工程研究

ABSTRACT

BACKGROUND: Related studies have shown that extracorporeal shock wave therapy has a positive effect on the treatment of knee osteoarthritis, but its effectiveness in treating knee osteoarthritis is not very clear, and the final results of various related studies are not same. OBJECTIVE: To analyze the efficacy of extracorporeal shock wave therapy for knee osteoarthritis using meta-analysis. METHODS: Chinese and English databases were searched in detail from inception to December 2019. The inclusion criteria were developed based on the Prisma principle to screen the randomized controlled trial of extracorporeal shock wave therapy for knee osteoarthritis. The treatment method of the experimental group was extracorporeal shock wave therapy or extracorporeal shock wave therapy combined with drugs and arthroscopic debridement. The treatment method of the control group was one of drug treatment, ultrasound treatment, laser treatment, exercise therapy, arthroscopy or blank control. The quality of the included literature was evaluated according to the Cochrane Handbook 5.1 bias risk assessment tool. Relevant data were analyzed using RevMan v5.3 software. RESULTS AND CONCLUSION: (1) A total of 21 randomized controlled trials were included, with a total of 1 736 patients with knee osteoarthritis, including 895 in the experimental group and 841 in the control group. (2) Meta-analysis shows that the visual analogue scale score of the experimental group was lower than that of the control group [SMD=-1.18, 95%CI(-1.42,-0.95), Z=9.75, P <0.000 01]. Joint motion range was greater in the experimental group than in the control group [SMD=-1.69, 95%CI(-2.01,-1.36), Z=10.16, P <0.000 01]. WOMAC score was lower in the experimental group than in the control group [SMD=-9.66, 95%CI(-13.12,-6.20), Z=5.47, P < 0.000 01]. (3) The results show that extracorporeal shock wave therapy for knee osteoarthritis has a certain positive effect on pain relief and joint motion range. However, the number of cases included in this study is small, and subsequent large-scale multi-center studies are needed to further clarify the relevant utility.