Efficacy and safety of acupoint catgut embedding for knee osteoarthritis: A systematic review and meta-analysis.

Researchers reviewed 28 studies involving 2,120 people to determine whether acupoint catgut embedding (ACE) helps with knee osteoarthritis pain. ACE is a treatment where absorbable thread material is inserted into acupuncture points, providing continuous stimulation as the body naturally absorbs it over time. The review examined studies comparing ACE combined with conventional treatments against conventional treatments alone, or against sham (fake) ACE procedures.

The findings showed that patients receiving ACE alongside conventional treatments experienced better pain relief and improved knee function compared to those receiving conventional treatments alone. The most commonly used acupuncture point in these studies was GB34 (Yanglingquan), located on the outer side of the lower leg. Patients in the ACE groups reported lower pain scores on the Visual Analog Scale and better outcomes on standardized knee function assessments. The combination approach also showed higher overall effectiveness rates.

However, the researchers caution that the quality of evidence was poor, with unclear methodology in many studies. This means while ACE appears promising for knee osteoarthritis, we cannot yet draw definitive conclusions about its effectiveness. The current evidence suggests potential benefits, but more rigorous research is needed to confirm whether ACE truly helps beyond placebo effects.

For patients with knee osteoarthritis, ACE might be worth considering as an addition to conventional care, though expectations should be tempered given the limited quality evidence. If you're interested in trying acupuncture or ACE for knee arthritis, seek a licensed acupuncturist with specialized training in catgut embedding techniques.

This systematic review and meta-analysis evaluated acupoint catgut embedding (ACE) for knee osteoarthritis across 28 randomized controlled trials (n=2,120). GB34 was the most frequently selected point. Primary outcomes included VAS and WOMAC scores; secondary outcomes assessed total effective rate and Lysholm scores. Meta-analysis demonstrated that ACE combined with conventional treatments significantly improved VAS scores, WOMAC indices, total effectiveness rates, and Lysholm scores compared to conventional treatments alone. When compared against sham ACE controls, the combination approach showed superior outcomes for VAS, WOMAC, and total effectiveness. However, the overall risk of bias was rated as unclear across studies, and evidence quality assessment using GRADE revealed poor methodological rigor. While results suggest ACE as adjunctive therapy may provide clinical benefit for knee OA management, the current evidence remains inconclusive. Well-designed, adequately powered RCTs with proper blinding and standardized protocols are needed before definitive clinical recommendations can be established for ACE in knee osteoarthritis treatment.