Rehabilitation with or without acupuncture for improving the knee function after total knee arthroplasty:A systematic review and meta-analysis
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Objective:To assess the effect and safety of acupuncture on the base of rehabilitation for knee function after total knee arthroplasty.Methods:Relevant articles were collected from CNKI,Sinomed,Wanfang,VIP,Cochrane Library,Medline and Embase.The search was conducted by using a combination of subject terms and free words.The data were analyzed by Revman 5.4 software,and the included studies were evaluated in compliance with the Cochrane Collaboration's tool for assessing risk of bias in randomized trials.Results:A total of 10 studies of randomized controlled trial(RCT)were included,with 785 participants in-volved,of which,393 cases in experiment group and 392 cases in control group.The interventions were electroacupuncture in 4 RCTs,filiform needling in 4 RCTs and transcutaneous electrical acupoint stim-ulation in 2 RCTs.Meta-analysis results showed that,compared with rehabilitation alone,acupuncture combined with rehabilitation improved the score of Hospital for Special Surgery(HSS)(MD=4.27,95％CI=[2.77,5.78],Z=5.58,P＜0.00001),increased the range of motion(ROM)of the knee(MD=3.09,95％CI=[1.47,4.70],Z=3.75,P＜0.001),and decreased the postoperative score of visual analogue scale(VAS)(MD=-0.53,95％CI=[-0.74,-0.33],Z=5.04,P＜0.00001),but the difference in VAS score between groups only indicated statistical significance,without clinical importance.The sensitivity analysis showed the re-sults were stable.In subgroup analysis,the stability of VAS score was relatively poorer in electroacupunc-ture group and filiform needle group,which may be associated with the differences in waveform of elec-troacupuncture and trial setting.Conclusion:Compared with rehabilitation alone,acupuncture in combination with rehabilitation could effectively improve the knee function for the patients after total knee arthroplasty.
NETL
NSTL
万方数据
