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Predictive Value of the Systemic Immune-Inflammation Index for the Clinical Efficacy of Acupuncture and Exercise Rehabilitation in Knee Osteoarthritis: A Retrospective Study.

Immunity, inflammation and disease·May 2026·Shifei Sun, Zhiyong Lu, Qing Yang et al.
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Key Finding

Lower baseline systemic immune-inflammation index, combined with lower BMI and higher lymphocyte count, independently predicted successful response to acupuncture and exercise therapy in knee osteoarthritis patients with moderate discriminative ability (AUC=0.858).

What This Means For You

Researchers in China investigated whether a blood test measuring inflammation levels could predict who would benefit most from acupuncture and exercise therapy for knee osteoarthritis. The study examined 151 patients with moderate knee arthritis who completed an 8-week program combining acupuncture with rehabilitation exercises. Scientists measured a marker called the systemic immune-inflammation index (SII) from routine blood tests taken before treatment began. They found that patients with lower inflammation levels, lower body weight, and higher lymphocyte counts were more likely to experience meaningful improvements in pain and function. About half the patients (73 of 151) achieved significant clinical improvement, defined as at least a 2-point reduction in pain scores and a 6-point improvement in knee function. When used alone, the SII showed moderate ability to predict treatment success. However, combining the inflammation marker with body mass index and lymphocyte count improved prediction accuracy. The findings suggest that simple blood tests might eventually help identify which knee osteoarthritis patients are most likely to respond well to acupuncture and exercise therapy. This could allow practitioners to personalize treatment approaches and set realistic expectations. The study had limitations including its retrospective design and single treatment center, so larger studies are needed to confirm these results. If you're considering acupuncture for knee osteoarthritis, seek care from a licensed acupuncturist with experience treating musculoskeletal conditions.

Clinical Notes for Practitioners

This retrospective study (n=151) evaluated whether baseline systemic immune-inflammation index (SII) predicts response to combined acupuncture and exercise rehabilitation in Kellgren-Lawrence Grade II-III knee osteoarthritis. Treatment response was defined as achieving MCII thresholds (≥2-point NRS reduction and ≥6-point WOMAC function improvement) after 8 weeks. Response rate was 48.3% (73/151). Multivariate logistic regression identified three independent predictors: lower BMI (OR=0.596), higher lymphocyte count (OR=34.597), and lower SII (OR=0.912). ROC analysis revealed moderate discriminative ability for SII alone (AUC=0.749, 95% CI: 0.670-0.828), improving to AUC=0.858 when combined with BMI and lymphocyte count. Clinical takeaway: While SII shows promise as an accessible biomarker for treatment stratification, its moderate predictive power suggests it should be combined with other clinical parameters. Single-center retrospective design and absence of longitudinal SII measurements limit generalizability; prospective validation studies are needed.

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