Comparison of the short-term efficacy of extracorporeal shock wave therapy for middle-aged and elderly knee osteoarthritis: a meta-analysis

doi:10.3969/j.issn.2095-4344.3767

Abstract

Abstract: OBJECTIVE: To compare the effectiveness of extracorporeal shock wave therapy with other treatments in relieving knee osteoarthritis pain and improving knee function in the elderly.
METHODS: A computer search was performed on PubMed, Embase, CNKI, and SinoMed databases to compare the efficacy of extracorporeal shock wave with the energy density of 0, non-steroidal drugs, and sodium hyaluronate for knee osteoarthritis. The search period was from the inception of the database to March 2020. Simultaneously, the obtained reference index was looked up. According to the incision and exclusion criteria, two researchers independently screened the literature. Visual analogue scale and The Western Ontario and McMaster Universities Osteoarthritis Index were the primary outcomes, and the Lequensne score was the secondary outcome. Cochrane bias risk assessment tool was used to evaluate literature quality. Data analysis was performed by RevMan 5.3 software.
RESULTS: (1) Twelve articles were included with a total of 1 040 patients, and all of them were randomized controlled trails. (2) Meta-analysis results showed that compared with the blank control, extracorporeal shock wave therapy could relieve the pain score of patients with knee osteoarthritis (MD=-2.00, 95%CI: -2.25 to -1.75, P < 0.000 01), improve The Western Ontario and McMaster Universities Osteoarthritis Index (MD=-8.45, 95%CI:-14.83 to -2.07, P=0.009) and Lequesne score (MD=-2.39, 95%CI:-4.24 to -0.54, P=0.01), with significant differences. (3) There was no significant difference between the group of extracorporeal shock wave and the group of non-steroidal drugs in terms of pain relief (MD=0.01, 95%CI:-0.48-0.51, P=0.95), but the effect of extracorporeal shock wave on improving knee function was better than that of non-steroidal drugs (MD=-6.56, 95%CI:-8.24 to -4.87, P < 0.000 01). (4) The knee pain (MD=0.22, 95%CI: 0.18, 0.25, P < 0.000 01) and The Western Ontario and McMaster Universities Osteoarthritis Index (MD=-1.29, 95%CI:-3.61 to -0.74, P=0.003) were improved in the group of extracorporeal shock wave compared with the group of sodium hyaluronate. (5) There was no significant difference in the scores of Lequesne (MD=-0.21, 95%CI:-1.09-0.67, P=0.64) between the group of extracorporeal shock wave and the group of sodium hyaluronate in terms of pain relief.
CONCLUSION: Compared with oral non-steroidal anti-inflammatory drugs and intra-articular sodium hyaluronate injection, extracorporeal shock wave shows a better clinical effect on relieving knee osteoarthritis pain and improving knee joint function. The above conclusions need to be verified through higher quality and larger sample clinical trial result.

Key words: bone, knee, knee joint, osteoarthritis, shock wave, sodium hyaluronate, pain, meta-analysis

CLC Number:

Huang Dengcheng, Wang Zhike, Cao Xuewei. Comparison of the short-term efficacy of extracorporeal shock wave therapy for middle-aged and elderly knee osteoarthritis: a meta-analysis[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(9): 1471-1476.

Figures/Tables 10

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