Comparison of the effects of acupotomy and acupuncture on knee osteoarthritis: A systematic review and meta-analysis.

BACKGROUND AND PURPOSE: Acupotomy and acupuncture are both treatments for knee osteoarthritis symptoms. However, acupotomy also has the additional anatomical effect of dissecting inflamed tissue. The problem this study aims to address is whether acupotomy is a better treatment than acupuncture in treating knee osteoarthritis. METHODS: We searched the PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Airiti Library, and Wanfang Data databases from inception to March 2022 for randomized controlled clinical trials (RCTs) comparing the effects of acupotomy and acupuncture in patients with knee osteoarthritis. RESULTS: In total, we identified 43 RCTs in this meta-analysis. Compared to the acupuncture group, acupotomy had a higher cure rate (odds ratio (OR) 2.94, 95% confidence interval (CI) 2.36 to 3.65), indicating a better improvement in daily activity function. Acupotomy was also more effective in pain relief and knee score improvement. However, some RCTs indicated that adverse events in the acupotomy group were greater than in the acupuncture group (OR 1.23, 95% CI 0.42 to 3.60). CONCLUSION: Our findings indicated that acupotomy was a more effective treatment for knee osteoarthritis than acupuncture. However, most of the included RCTs had moderate risk of bias, meaning that more high-quality RCTs were needed.

Effect of hyaluronic acid on radiodermatitis in patients with breast cancer: a meta-analysis of randomized controlled trials.

BACKGROUND: Radiodermatitis is commonly experienced by patients with breast cancer undergoing radiotherapy, affecting their quality of life and potentially leading to cancer treatment postponement. Recently, people who use natural substances to treat radiodermatitis have attracted more and more attention. However, there is no unanimous conclusion to follow. OBJECTIVE: We conducted a meta-analysis of randomized controlled trials (RCTs) that compared hyaluronic acid with other topical agents in patients with breast cancer. METHODS: PubMed, Cochrane Library, and Embase databases were searched for eligible articles. The primary outcome indicating symptom relief was a decreased radiodermatitis grade. The secondary outcome indicating symptom relief was preference and desquamation. The study is registered with PROSPERO (number: CRD42021237793). RESULTS: Eight RCTs that together enrolled 500 patients were analyzed. Six studies assessed the radiodermatitis grade and found significant differences in three of eight subgroups. The subgroups comparing hyaluronic acid with phytosterol, omega-3, 6, 9, and vitamin E showed significantly lower risk ratios. In two subgroups, the effect of hyaluronic acid was not significantly different from that of grapevine extract and Avene thermal water. The remaining three studies reported that other topical agents exerted a nonsignificantly better effect than hyaluronic acid did. Physicians' preference was better for the control group, while the patients' preference for hyaluronic acid was better, and there was no statistical difference. In addition, our study showed that desquamation events were few in the hyaluronic group. CONCLUSIONS: Hyaluronic acid can show a better effect than other topical drugs and the lower incidence in desquamation events. Since hyaluronic acid has no obvious side effects, we recommend it as one of the alternative options. Further research is required to evaluate this effect comprehensively.

Effects of Low-Level Laser Therapy on Muscular Performance and Soreness Recovery in Athletes: A Meta-analysis of Randomized Controlled Trials.

CONTEXT: Athletes must maintain their peak state of strength. Previous studies have investigated the effect of low-level laser therapy (LLLT) on muscular performance. A previous systematic review and meta-analysis has investigated this issue in healthy participants but not in physically active athletes. OBJECTIVE: To investigate whether LLLT can improve muscular performance and soreness recovery in athletes. DATA SOURCES: PubMed, EMBASE, and Cochrane Library. STUDY SELECTION: Published randomized controlled trials and crossover studies till December 2020. STUDY DESIGN: Systematic review and meta-analysis. LEVEL OF EVIDENCE: Level 3. DATA EXTRACTION: Assessment of study quality was rated using the risk of bias assessment method for randomized trials (Cochrane Handbook for Systematic Reviews of Interventions). RESULTS: A total of 24 studies were included. LLLT application before exercise significantly improved lower-limb muscle strength in 24-hour, 48-hour, 96-hour, and 8-week follow-up groups. Furthermore, decreased soreness index, serum creatine kinase concentrations, interleukin-6, and thiobarbituric acid reactive substance concentrations and a trend toward the improvement of contract repetition number and VO2 kinetic outcomes were observed. CONCLUSION: Although a definite therapeutic effect of LLLT is yet to be established, the current evidence supports that LLLT use improves muscular performance in physically active athletes. Additional trials with large sample sizes and robust design should be conducted before strong recommendations are made.