Article Text

Is acupuncture effective for knee osteoarthritis? A protocol for a systematic review and meta-analysis
  1. Chuan-Yang Liu1,2,
  2. Jian-Feng Tu3,
  3. Myeong Soo Lee4,
  4. Ling-Yu Qi3,
  5. Fang-Ting Yu3,
  6. Shi-Yan Yan3,
  7. Jin-Ling Li3,
  8. Lu-Lu Lin3,
  9. Xiao-Wan Hao3,
  10. Xin-Tong Su3,
  11. Jing-Wen Yang3,
  12. Li-Qiong Wang3
  1. 1School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
  2. 2School of Traditional Chinese Medicine, Capital Medical University, Beijing, China
  3. 3School of Acupuncture-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing, China
  4. 4KM Science Research division, Korea Institute of Oriental Medicine, Daejon, South Korea
  1. Correspondence to MD Li-Qiong Wang; wangliqiongwork{at}; MD Jing-Wen Yang; yangjw0626{at}


Introduction Knee osteoarthritis (KOA) is one of the leading causes of disability. The effectiveness of acupuncture for treating KOA remains controversial. This protocol describes the method of a systematic review and meta-analysis evaluating the effectiveness and safety of acupuncture for treating KOA.

Methods and analysis Four English databases (PubMed, Embase, Cochrane Library databases and Web of Science) and four Chinese databases (China National Knowledge Infrastructure, Chinese Biomedical Literature Database, VIP Database for Chinese Technical Periodicals, and Wanfang) will be searched from the database inception to 1 September 2021. All randomised controlled trials related to acupuncture for KOA will be included. Extracted data will include publication details, basic information, demographic data, intervention details and patient outcomes. The primary outcome will be pain intensity. Risk of bias will be assessed using the Cochrane Collaboration’s tool for assessing risk of bias. Article selection, data extraction and risk of bias assessment will be performed in duplicate by two independent reviewers. If the meta-analysis is precluded, we will conduct a descriptive synthesis using a best-evidence synthesis approach. The strength of recommendations and quality of evidence will be assessed using the Grading of Recommendations Assessment Development and Evaluation working group methodology.

Ethics and dissemination Ethics approval is not required because individual patient data are not included. This protocol was registered in the international Prospective Register of Systematic Reviews on 25 February 2021. The systematic review and meta-analysis will be submitted for publication in a peer-reviewed journal. The findings will also be disseminated through conference presentations.

Trial registration number CRD42021232177.

  • knee
  • protocols & guidelines
  • complementary medicine

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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Supplementary materials


  • Contributors C-YL is the guarantor and first author of the protocol. C-YL and L-QW designed the systematic review. C-YL and L-LL drafted the manuscript. J-WY, J-FT, L-QW and M-SL provided help to design and edited the manuscript. C-YL and F-TY will independently screen the eligible studies. C-YL and X-WH will extract data from included articles. J-LL and J-FT will assess the risk of bias. C-YL and X-TS will assess acupuncture adequacy, strength of recommendations and the quality of evidence. C-YL, L-YQ and S-YY will finish data synthesis. L-QW will arbitrate any disagreements during the review. All authors have read the manuscript and approved the final publication of the protocol.

  • Funding This study was supported in part by the National Natural Science Foundation of China (grant number 82004223).

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.