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Journal of Traditional Chinese Medicine >

2024 , Vol. 44 >Issue 2: 243 - 250

DOI: https://doi.org/10.19852/j.cnki.jtcm.20231226.002

Meta-Analyses

Efficacy and safety of extracorporeal shock wave therapy combined with sodium hyaluronate in treatment of knee osteoarthritis: a systematic review and Meta-analysis

  • Mingwang ZHOU ,
  • Zhuanli DONG ,
  • Changhao WEI ,
  • Lufang FENG ,
  • Xiaoping WANG ,
  • Haiping LIU ,
  • Xing JI ,
  • Kehu YANG ,
  • Shenghua LI
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  • 1 Department of Orthopaedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou 730050, China
    2 Department of Quality Management, Lanzhou Petrochemical General Hospital, Lanzhou 730050, China
    3 Department of Orthopaedics, Lanzhou Petrochemical General Hospital, Lanzhou 730050, China
    4 Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, 730000, China
    5 Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou 730000, China
    6 Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, Lanzhou 730000, China
    7 Center for Translational Medicine, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou 730050, China
    8 Department of Orthopaedics, Gansu Provincial Hospital of Traditional Chinese Medicine, Lanzhou 730000, China

Received date: 2022-09-26

  Accepted date: 2023-01-18

  Online published: 2023-12-26

Supported by

Natural Science Foundation-funded Project: Yang Deficiency Constitution of Knee Osteoarthritis and the Wnt/β-catenin Signaling Pathway Regulates the Level of Correlation, and the Constitution Theraphy(81260546);Construction Project of Chinese Medicine Inheritance Innovation Platform: Basic and Clinical Application Research on Osteoarthritis of the Knee(Gan Wei Chinese Medicine Letter [2020] No. 203);Gansu Provincial Science and Technology Plan Project: Clinical Medical Research Centre for Bone and Joint Degenerative Diseases(18JR2FA009)

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Abstract

OBJECTIVE: To assess the efficacy and safety of extracorporeal shockwave therapy (ESWT) combined with sodium hyaluronate (HA) for the treatment of knee osteoarthritis (KOA).

METHODS: PubMed, Embase, the Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang database, China Science and Technology Journal Database, and SinoMed were searched from inception to July 2020. The quality of the randomized controlled trials was evaluated independently by two reviewers according to the criteria in the Cochrane Collaboration for Systematic Reviews. The identified articles were then screened individually using EndnoteX9 for eligibility in this Meta-analysis. The heterogeneity among the articles was evaluated using I2.

RESULTS: A total of 17 studies, comprising 2000 individuals, were included in this Meta-analysis. The results showed that a significant improvement was observed in knee pain and function based on the clinical efficacy of ESWT combined with HA. Statistical analysis of clinical efficacy showed that [relative risk (RR) = 1.21, 95% confidence interval (CI) (1.12, 1.30), P < 0.01]. Statistical analysis of visual analog scale showed that [standardized mean difference (SMD) = －2.84, 95%CI (－4.01, －1.66), P < 0.01]. Western Ontario and McMaster University osteoarthritis index statistical analysis showed that [SMD = －1.57, 95% CI (－2.52, －0.61), P < 0.01]. Lysholm score statistical analysis showed that [SMD = 1.71, 95% CI (0.98, 2.44), P < 0.01]. In addition, only minor side effects, such as redness and swelling of the skin, were observed.

CONCLUSIONS: Medium to low quality evidence showed that ESWT combined with HA offers an inexpensive, well-tolerated, safe, and effective method to improve pain and functionality in patients with KOA. However, tightly controlled, randomized, large multicenter trials are warranted to validate the current findings.

Key words： osteoarthritis, knee; randomized controlled trial; extracorporeal shockwave therapy; hyaluronic acid; Meta-analysis

Cite this article

Mingwang ZHOU , Zhuanli DONG , Changhao WEI , Lufang FENG , Xiaoping WANG , Haiping LIU , Xing JI , Kehu YANG , Shenghua LI . Efficacy and safety of extracorporeal shock wave therapy combined with sodium hyaluronate in treatment of knee osteoarthritis: a systematic review and Meta-analysis[J]. Journal of Traditional Chinese Medicine, 2024 , 44(2) : 243 -250 . DOI: 10.19852/j.cnki.jtcm.20231226.002

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