Abstract
OBJECTIVE: To systematically evaluate the effectiveness of the combined Needle Knife Therapy (NKT) and Chinese Herbal Medicine (CHM) treatment for knee osteoarthritis (KOA) and to provide clinical evidence supporting its application in managing the condition. METHODS: Relevant articles were retrieved from PubMed, Medline, Embase, Wanfang, and China National Knowledge Network (CNKI) from the inception of the databases up to February 18, 2023. Randomized controlled trials (RCTs) on the efficacy of NKT combined with CHM were appraised for inclusion. The meta-analysis was conducted using RevMan 5.3 and was registered with the International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) (202470051). RESULTS: A total of 11 RCTs involving 880 patients were included. The meta-analysis showed that the combined therapy was superior to NKT alone in the treatment of KOA [relative risk (RR) = 1.09; 95% confidence interval (CI): (1.03, 1.14); P = 0.002]. The combined therapy showed a significant reduction in the Visual Analog Scale (VAS) score [RR = -0.98; 95% CI: -1.12, -0.84; P < 0.00001] and symptom scores [RR = -1.75; 95% CI: (-1.87, -1.63); P < 0.00001] compared to single NT therapy. There was no significant difference in the Traditional Chinese Medicine (TCM) syndrome scores between the two groups [RR = -0.23; 95% CI: (-0.56, 0.10); P = 0.18]. Furthermore, we observed a marked increase in lysholmy scores in the combination group than in the control group [RR = -1.04; 95% CI: (-1.31, -0.77); P < 0.00001]. CONCLUSIONS: The combination of needle-knife therapy and Chinese herbal medicine exhibits promising clinical efficacy in the treatment of KOA.