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Evidence-Based Complementary and Alternative Medicine
Volume 2013 (2013), Article ID 427265, 7 pages
Research Article

Objectifying Specific and Nonspecific Effects of Acupuncture: A Double-Blinded Randomised Trial in Osteoarthritis of the Knee

1Department of Internal Medicine, Heidelberg University Hospital, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany
2Centre for Chinese Medicine, Universitätsallee 3, 28359 Bremen, Germany
3German Society for Traditional Chinese Medicine (DGTCM), Heidelberg University, Karlsruher Straße 12, 69126 Heidelberg, Germany
4Institute of Public Health, Social and Preventive Medicine, Mannheim Medical Faculty, Heidelberg University, Ludolf-Krehl-Straße 7-11, 68167 Mannheim, Germany
5Shen-Centre for Traditional Chinese Medicine, Südliche Stadtmauer Straße 25, 91054 Erlangen, Germany
6Department of Society, Human Development and Health, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA
7Abel Salazar Biomedical Sciences Institute, University of Porto, Rua de Jorge Viterbo Ferreira No. 228, 4050-313 Porto, Portugal

Received 23 September 2012; Accepted 13 December 2012

Academic Editor: Jaung-Geng Lin

Copyright © 2013 Max Karner et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. Acupuncture was recently shown to be effective in the treatment of knee osteoarthritis. However, controversy persists whether the observed effects are specific to acupuncture or merely nonspecific consequences of needling. Therefore, the objective of this study is to determine the efficacy of different acupuncture treatment modalities. Materials and Methods. We compared between three different forms of acupuncture in a prospective randomised trial with a novel double-blinded study design. One-hundred and sixteen patients aged from 35 to 82 with osteoarthritis of the knee were enrolled in three study centres. Interventions were individualised classical/ modern semistandardised acupuncture and non-specific needling. Blinded outcome assessment comprised knee flexibility and changes in pain according to the WOMAC score. Results and Discussion. Improvement in knee flexibility was significantly higher after classical Chinese acupuncture (10.3 degrees; 95% CI 8.9 to 11.7) as compared to modern acupuncture (4.7 degrees; 3.6 to 5.8). All methods achieved pain relief, with a patient response rate of 48 percent for non-specific needling, 64 percent for modern acupuncture, and 73 percent for classical acupuncture. Conclusion. This trial establishes a novel study design enabling double blinding in acupuncture studies. The data suggest a specific effect of acupuncture in knee mobility and both non-specific and specific effects of needling in pain relief.