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 commonlocation is the knee.Objectives: The aim of this study was to determine the effect of acupuncture treatment andphysiotherapy 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 universityhospital.Methods: One hundred patients with KOA were randomly divided into the acupuncture group andthe physiotherapy group. Both treatments were given in 12 sessions over 6 weeks. Thirteen acupuncturepoints were selected for the knee. Local points were GB34, SP10, SP9, ST36, ST35, ST34, EX-LE2, EXLE5,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 OsteoarthritisIndex (WOMAC) and the 36-Item Short Form Health Survey (SF-36) were used to determine functionalstatus and health-related QOL, respectively. All patients were evaluated at baseline, after the lasttreatment, and at the 12-week follow-up period.Results: There was no statistically significant difference between the acupuncture group andphysiotherapy group in terms of pain, total WOMAC, and SF-36 levels at baseline, after treatment, andat 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 to5.54 ± 2.34; and physiotherapy, from 7.86 ± 1.9 to 5.68 ± 2.42; P < 0.05) at the 12-week follow-up ofthe 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 similareffects with regard to pain, functional status, and QOL. There were no significant differences betweenthe acupuncture and physiotherapy groups in relief of pain, improved functional status, and QOL in thetreatment of KOA. Both acupuncture and physiotherapy treatments were found to yield significantlysuperior results when compared with baseline values.Key words: Knee osteoarthritis, acupuncture, physiotherapy, randomized clinical trial