Osteoarthritis most frequently affects the knee joint. Despite a limited evidence base, arthritis patients are increasingly turning to acupuncture, especially as side-effects of non-steroidal anti-inflammatory drugs are common and wide-ranging.

Around 300 Patients with chronic osteoarthritis of the knee were randomly assigned to acupuncture, minimal (sham) acupuncture (superficial needling at non-acupuncture points), or a waiting list control. Patients were allowed to use non-steroidal anti-inflammatory drugs throughout the study. Physicians administered acupuncture and minimal acupuncture in 12 sessions over 8 weeks. Patients completed questionnaires at the start of treatment, and after 8 weeks, 6 months, and 1 year.

Analgesic use was similar for patients in the three groups. After 8 weeks, patients given acupuncture had a substantially lower score on an established osteoarthritis index than patients in the control group (26 points and 50 points, respectively). Minimal acupuncture also had short-term benefit compared with no acupuncture (36 points on the osteoarthritis index). However, at 1-year follow-up there was no significant difference in scores between the three groups.

Lead investigator Claudia Witt (Charite University Medical Center, Berlin, Germany) comments: "Acupuncture treatment had significant and clinically relevant short-term effects when compared to minimal acupuncture or no acupuncture treatment in patients with osteoarthritis of the knee. We now need to assess the long-term effects of acupuncture, both in comparison to sham interventions and to standard treatment."

In an accompanying Comment, Andrew Moore (Pain Research, University of Oxford, UK), states: "The bottom line from Witt and colleagues' large,
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Contact: Joe Santangelo
j.santangelo@elsevier.com
1-212-633-3810
Lancet
7-Jul-2005