Efficacy of ultrasound-guided acupotomy for knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials

Lin, Sixiong; Lai, Chuanshi; Lin, Yan‐Hui; Tu, Yinyong; Ying, Yang; Zhang, Renpan

doi:10.1097/md.0000000000032663

Cited by 5 publications

(5 citation statements)

References 30 publications

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“…Recently, studies on ultrasound guide procedures have been reported to increase the accurate depth of the needle and the accuracy of the treatment area. 25,26 It is thought that further research is needed on this method. Adverse effects in relation to either acupotomy alone or combination treatment did not occur, and there were no significant differences in…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and Safety of Acupotomy on Lumbar Spinal Stenosis: A Pragmatic, Pilot, Randomized Controlled Trial

Lee¹,

Lee²,

Woo³

et al. 2023

JPR

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In Korea, complex treatments such as acupotomy, acupuncture, and physical therapy are performed for lumbar spinal stenosis (LSS). Although there are reports of acupotomy as monotherapy or acupuncture treatment for LSS, pragmatic studies are lacking. Therefore, this study aimed to determine the effectiveness and safety of acupotomy for LSS to provide baseline evidence for a large-scale study. Materials and Methods: This pragmatic randomized controlled pilot study enrolled 34 participants and randomly assigned them to two groups (n=17/group). The intervention was conducted for 8 weeks. Acupotomy plus and usual care groups received acupuncture (17 acupoints) and interferential current therapy (ICT) twice weekly; however, the acupotomy plus group received an additional acupotomy (7 acupoints) for treatment of the usual care group. The primary outcome was measured using visual analog scales (VAS), and secondary outcomes were assessed using the self-rated walking distance, short-form McGill Pain Questionnaire (SF-MPQ), and the Oswestry Disability Index (ODI). Outcome measurements were conducted at baseline and 4, 8, and 12 weeks after the commencement of the intervention. Adverse events were assessed at each visit. Hematological and biochemical examinations were performed at screening and week 8. Results: Overall, 33 of the 34 participants completed the study, and one participant in the usual care group dropped out. In both groups, VAS scores at weeks 4, 8, and 12 significantly improved compared to baseline. Also, self-rated walking distance, SF-MPQ, and ODI scores were significantly improved at weeks 4, 8, and 12 than at baseline. However, there were no significant differences in the time-dependent and group-to-time interactions between the two groups. In addition, no severe adverse reactions were reported, and there were no significant differences in hematological and biochemical results. Conclusion:This study provides baseline data for large-scale studies on the effectiveness and safety of acupotomy in LSS. Clinical Trial Number: KCT0006234.

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Section: Discussionmentioning

confidence: 99%

Effectiveness and Safety of Acupotomy on Lumbar Spinal Stenosis: A Pragmatic, Pilot, Randomized Controlled Trial

Lee¹,

Lee²,

Woo³

et al. 2023

JPR

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“…In this survey, many respondents reported local AEs such as pain, bruising, hematomas, and bleeding due to vascular damage. However, the subgroup analysis indicated that these side effects can be minimized when utilizing medical imaging devices actively during procedures, highlighting the importance of their active utilization [ 30 ]. Regarding systemic AEs, fatigue and autonomic nervous system dysfunctions (headache, nausea, dizziness, sweating, etc.)…”

Section: Discussionmentioning

confidence: 99%

“…The needling depth may vary depending on gender, body mass index, and treatment area. The absence of navigational imaging devices may cause serious AEs [ 14 , 15 , 30 ]. Therefore, it is necessary to provide guidelines for safety procedures, including potential AEs based on individual patient characteristics, and procedural guidelines utilizing medical imaging devices, including safe needling depths [ 37 ].…”

Section: Discussionmentioning

confidence: 99%

Acupotomy in Korean Medicine Doctors: A Preliminary Survey on Experiences, Perceptions, and Clinical Usage Status

Jun,

Yoon,

Ryu

et al. 2023

Healthcare

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Acupotomy is a widely used medical intervention in traditional East Asian medicine, and efforts are being made to improve its effectiveness and safety. As a first step toward establishing more standardized procedural guidelines, a survey was conducted to explore the current clinical practice status and perceived adverse events (AEs) by Korean Medicine (KM) practitioners. The survey was developed via expert consensus and included information on clinical usage, perception, and the AEs experienced. The largest acupotomy society in Korea, which consists of 185 KM doctors, participated in an online survey conducted in September 2021. Of the 185 KM doctors, 107 (57.8%) responded. Musculoskeletal and connective tissue diseases accounted for 80.8% of suggested indications by KM doctors. Regarding the detailed procedure, there were considerable discrepancies between KM doctors. The most frequent acupotomy-related AEs observed by KM practitioners were bruises (77.3%), fatigue (57.7%), pain (51.8%), and hematoma (51.8%). Only 1.8% of the respondents answered that they had experienced severe AEs. Survey respondents answered that the use of imaging devices during acupotomy and the development of clinical practice guidelines are the most necessary policy requirements for promoting the use and ensuring the safety of acupotomy. To the best of our knowledge, this study marks the initial exploration into the KM physicians’ clinical usage status, AEs experienced, and their requests for standardized guidelines and expanded health insurance coverage concerning acupotomy. Further research should include qualitative studies to assess patient experience and prospective observational studies to examine the effects of operator skills and treatment modalities on AEs and adherence.

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“…In China, ultrasound-guided acupotomy was more effective in reducing pain than unguided acupotomy for patients with knee osteoarthritis in several randomized controlled trials. [8] In Korea, several retrospective studies reported positive effects of ultrasoundguided pharmacopuncture for the treatment of various musculoskeletal disorders, such as rib fracture and acute lower back pain. [9][10][11][12][13][14][15] Through these reports, it can be inferred that ultrasoundguidance is actively applied in the clinical practice of KM.…”

Section: Introductionmentioning

confidence: 99%

Survey on the current usage of ultrasound-guided procedures in Korean Medicine Clinics and Hospitals

Kim,

Yun,

Lee

et al. 2024

Medicine

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Ultrasound-guidance is applied during the administration of Korean medicine (KM) interventions to improve the safety and effectiveness of the interventions. Although many case series and reports on the use of ultrasound-guided KM interventions have been reported, no study has investigated the current use of ultrasound-guidance in clinical practice by doctors of Korean medicine (KMDs). An online survey was conducted with questions examining the status of ultrasound-guidance usage among KMDs practicing in various KM clinical settings. Survey responses from 335 KMDs were collected. Ultrasound started to be widely used in the clinical practice of KM since 2022. The primary objective of using ultrasound-guidance was “To improve the accuracy and efficacy” by 54.6%. Ultrasound-guidance was most frequently applied for shoulder joint diseases, and pharmacopuncture was the most frequently used intervention (76.1% and 90.4%, respectively). The respondents reported that effectiveness could be enhanced the most in nerve entrapment syndromes and especially when used in shoulder joints. Over 90% of KMDs responded that the safety and efficacy of treatment, specialty, and patients’ satisfaction were improved after adopting ultrasound-guidance. Moreover, 94.9% of KMDs agreed with the necessity for reimbursement of ultrasound-guidance in KM under national health insurance coverage. Most KMDs responded that they had positive perceptions regarding the clinical use of ultrasound-guidance in KM in terms of treatment effects, safety, and patient satisfaction, and the need for national health insurance coverage of the service. Our findings may provide practice-based evidence for conducting clinical studies.

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Efficacy of ultrasound-guided acupotomy for knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials

Cited by 5 publications

References 30 publications

Effectiveness and Safety of Acupotomy on Lumbar Spinal Stenosis: A Pragmatic, Pilot, Randomized Controlled Trial

Effectiveness and Safety of Acupotomy on Lumbar Spinal Stenosis: A Pragmatic, Pilot, Randomized Controlled Trial

Acupotomy in Korean Medicine Doctors: A Preliminary Survey on Experiences, Perceptions, and Clinical Usage Status

Survey on the current usage of ultrasound-guided procedures in Korean Medicine Clinics and Hospitals

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