SYSTEMATIC REVIEW article
Front. Med.
Sec. Rheumatology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1602699
Fu's subcutaneous needling for knee osteoarthritis: A systematic review and meta-analysis
Provisionally accepted
- 1The First Clinical Medical College, College of Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
- 2Department of Rheumatology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
- 3Tianjin University of Traditional Chinese Medicine, Tianjin, China
- 4Department of Pharmacy, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, China
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Background: Acupuncture has been listed as an alternative treatment in several knee osteoarthritis (KOA) international guidelines. Fu's subcutaneous needling (FSN), as a novel acupuncture therapy, has shown greater potential for treating KOA. The objective of this systematic review is to compare the efficacy and safety of FSN to routine acupuncture therapy (RAT) for KOA.: China National Knowledge Infrastructure, VIP, China Biomedical Literature Database, Wanfang Medical, Embase, PubMed, Ovid, and the Cochrane Library were searched from inception to March 2025, and randomized controlled trials on FSN for KOA were included. The primary outcomes were total efficacy rate, Visual Analog Scale (VAS) pain scores and Western Ontario and McMaster Universities Arthritis Index (WOMAC) scores. Literature quality was assessed using Cochrane risk-of-bias tool 1.0. Heterogeneity among trials was assessed using the Cochrane Q test and I 2 values, determining model selection (fixed/random effects).The meta-analyses of included studies used odds ratios and mean differences when appropriate, along with significance threshold α=0.1. The evidence was evaluated by the GRADE guideline. The PROSPERO International Prospective Register of Systematic Reviews received this research for registration (CRD42024595903).Results: A total of 14 studies were included(1186 patients, with 594 in FSN group and 592 in RAT group). Primary outcomes: The total efficacy rate of the FSN group was significantly higher than that of the RAT group (OR=3.83, 95%CI [2.36,6.91] P < 0.01, n=10, 470/467 participants). FSN also demonstrated greater effectiveness in reducing VAS pain scores (MD=-1.44, 95%CI [-1.62,-1.26] P < 0.01, n=6, 205/206 participants) and WOMAC scores (MD=-6.07, 95%CI [-8.16,-3.97] P < 0.01, n=5, 160/161 participants). Secondary outcomes: FSN group showed a greater reduction in inflammatory cytokines: IL-6 (MD=-1.50 ng/ml, 95%CI [-1.55,-1.46] P < 0.01, n=4, 180/180 participants), TNF-α (MD=-2.26 pg/ml, 95%CI [-2.30,-2.23] P < 0.01, n=4, 180/180 participants). Conclusion: Compared to RAT for KOA, FSN demonstrates superior efficacy in alleviating pain, reducing inflammation, and improving joint dysfunction. Further high-quality studies are needed to determine the long-term efficacy of FSN.
Keywords: Acupuncture, Fu's Subcutaneous Needling, Meta-analysis, Osteoarthritis, randomized controlled trials
Received: 30 Mar 2025; Accepted: 22 Jul 2025.
Copyright: © 2025 Zhao, Liu, Li, Si, Tian, Zhang and Jiang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Xiaohu Zhao, The First Clinical Medical College, College of Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
Deke Zhang, Department of Pharmacy, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250011, Shandong Province, China
Ping Jiang, Department of Rheumatology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, 250011, Shandong Province, China
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