Ultrasound-guided dry needling versus traditional dry needling for patients with knee osteoarthritis: A double-blind randomized controlled trial

Johnson C Y Pang; Amy S N Fu; Stanley K H Lam; B Peng; Allan C L Fu

doi:10.1371/journal.pone.0274990

Ultrasound-guided dry needling versus traditional dry needling for patients with knee osteoarthritis: A double-blind randomized controlled trial

PLoS One. 2022 Sep 30;17(9):e0274990. doi: 10.1371/journal.pone.0274990. eCollection 2022.

Authors

Johnson C Y Pang¹, Amy S N Fu², Stanley K H Lam^{3

4

5}, B Peng⁶, Allan C L Fu^{7

8}

Affiliations

¹ School of Health Sciences, Caritas Institute of Higher Education, Hong Kong, China.
² Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China.
³ The Hong Kong Institute of Musculoskeletal Medicine, Hong Kong, China.
⁴ Department of Family Medicine, The Chinese University of Hong Kong, Hong Kong, China.
⁵ Department of Family Medicine, The University of Hong Kong, Hong Kong, China.
⁶ Department of Rehabilitation Medicine, Sichuan Provincial People's Hospital, Chinese Academy of Sciences Sichuan Translational Medicine Research Hospital, University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
⁷ Discipline of Physiotherapy, Sydney School of Health Sciences, The University of Sydney, Sydney, Australia.
⁸ Musculoskeletal Research Hub, Charles Perkins Centre, The University of Sydney, Sydney, Australia.

Abstract

Objective: To compare the effect of ultrasound (US)-guided dry needling (DN) with traditional DN in the treatment of pain and dysfunction for patients with knee osteoarthritis (KOA).

Design: A double-blind, randomized controlled trial.

Methods: Patients (25 male and 65 female), age 50-80 years diagnosed with KOA were recruited and randomly assigned to one of three groups in a 1:1:1 ratio for intervention: real US-guided DN with exercise therapy (G1), placebo US-guided DN with exercise therapy (G2), and exercise therapy solely (G3). G1 and G2 were blinded to the application of real or placebo US guidance by turning the monitor of US imaging out-of-view from participants' vantage points. The effectiveness of blinding was evaluated by asking the participants whether they had received real-US guided DN. The responses were assessed by Chi-square test. Visual Analogue Scale (VAS), Knee injury, and Osteoarthritis Outcome Score (KOOS) subscales (KOOS-pain, KOOS-symptoms, KOOS-quality-of-life (QoL)) were collected at baseline, 4 weeks, and 8 weeks by a blinded assessor. Data were analyzed by mixed model analysis of variance (ANOVA) with Bonferroni correction.

Results: Eighty-four participants (61.26±5.57 years) completed the study. G1 achieved significant improvement in VAS at 8 weeks compared to G2 and G3 (G1 vs. G2: MD = -15.61, 95% CI [-25.49, -5.51], p = 0.001; G1 vs. G3: MD = -19.90, 95% CI [-29.71, -10.08], p< 0.001). G1 achieved significant improvement in KOOS-pain at 8 weeks compared to G2 and G3 (G1 vs. G2: MD = 9.76, 95% CI [2.38, 17.14], p = 0.006; G1 vs. G3: MD = 9.48, 95% CI [2.31, 16.66], p = 0.010). KOOS-symptoms and KOOS-QoL were not statistically significant between groups. G2 had no significant difference of the perceptions as G1 with p = 0.128. G2 were successfully blinded to placebo US-guided DN.

Conclusion: US-guided DN with exercise therapy may be more effective than traditional DN with exercise therapy or exercise therapy alone in reduce pain of KOA.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Aged
Aged, 80 and over
Dry Needling*
Female
Humans
Male
Middle Aged
Osteoarthritis, Knee* / diagnostic imaging
Osteoarthritis, Knee* / therapy
Pain
Quality of Life
Treatment Outcome
Ultrasonography, Interventional

Grants and funding

This work was supported by the grant from the Caritas Institute of Higher Education for publication with reference code: IDG200101. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.