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• W2159073054 abstract "In Osteoarthritis and Cartilage, Corbett MS and colleagues1Corbett M.S. Rice S.J. Madurasinghe V. Slack R. Fayter D.A. Harden M. et al.Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis.Osteoarthritis Cartilage. 2013; 21: 1290-1298Abstract Full Text Full Text PDF PubMed Scopus (110) Google Scholar provided evidence that acupuncture can be considered as one of the more effective physical treatments for alleviating osteoarthritis knee pain in the short-term. This is a huge task that we really appreciate. However, after reading the paper carefully, we also found some worthwhile issues worth being explored. Firstly, as illustrated by some previous studies2Wang S.Y. Olson-Kellogg B. Shamliyan T.A. Choi J.Y. Ramakrishnan R. Kane R.L. Physical therapy interventions for knee pain secondary to osteoarthritis: a systematic review.Ann Intern Med. 2012; 157: 632-644Crossref PubMed Scopus (72) Google Scholar, 3Shamliyan T.A. Wang S.Y. Olson-Kellogg B. Kane R.L. Physical Therapy Interventions for Knee Pain Secondary to Osteoarthritis [Internet]. Agency for Healthcare Research and Quality (US), Rockville (MD)2012Google Scholar, shortwave diathermy and electrical stimulation (including transcutaneous electrical nerve stimulation (TENS)) were two different kinds of physical therapies. However, three studies4Callaghan M.J. Whittaker P.E. Grimes S. Smith L. An evaluation of pulsed shortwave on knee osteoarthritis using radioleucoscintigraphy: a randomised, double blind, controlled trial.Joint Bone Spine. 2005; 72: 150-155Crossref PubMed Scopus (31) Google Scholar, 5Fukuda T.Y. Alves da Cunha R. Fukuda V.O. Rienzo F.A. Cazarini C. Carvalho Nde A. et al.Pulsed shortwave treatment in women with knee osteoarthritis: a multicenter, randomized, placebo-controlled clinical trial.Phys Ther. 2011; 91: 1009-1017Crossref PubMed Scopus (30) Google Scholar, 6Fukuda T.Y. Ovanessian V. Cunha R.A.D. Filho Z.J. Cazarini C. Rienzo F.A. et al.Pulsed short wave effect in pain and function in patients with knee osteoarthritis.J Appl Res. 2008; 8: 189-198Google Scholar which compared pulsed shortwave treatments with placebo group were categorized into the pulsed electrical stimulation group according to the supplementary material, while the rest of the studies which focused on shortwave diathermy were included into the heat treatment group correctly. In addition, the study conducted by Giombini et al.7Giombini A. Di Cesare A. Di Cesare M. Ripani M. Maffulli N. Localized hyperthermia induced by microwave diathermy in osteoarthritis of the knee: a randomized placebo-controlled double-blind clinical trial.Knee Surg Sports Traumatol Arthrosc. 2011; 19: 980-987Crossref PubMed Scopus (22) Google Scholar should have been categorized into microwave diathermy rather than shortwave diathermy. Furthermore, unlike other forms of electrical stimulation, noninvasive interactive neurostimulation (NIN) could adjust the impulses it sends out and thereby provide an optimal stimulation for pain control8Gorodetskyi I.G. Gorodnichenko A.L. Tursin P.S. Reshetnyak V.K. Uskov O.N. Non-invasive interactive neurostimulation in the post-operative recovery of patients with a trochanteric fracture of the femur. A randomized, controlled trial.J Bone Joint Surg Br. 2007; 89: 1488-1494Crossref PubMed Scopus (28) Google Scholar, 9Selfe T.K. Bourguignon C. Taylor A.G. Effects of noninvasive interactive neurostimulation on symptoms of osteoarthritis of the knee: a randomized, sham-controlled pilot study.J Altern Complement Med. 2008; 14: 1075-1081Crossref PubMed Scopus (16) Google Scholar. Inexplicably, the authors regarded NIN as TENS without specific explanation9Selfe T.K. Bourguignon C. Taylor A.G. Effects of noninvasive interactive neurostimulation on symptoms of osteoarthritis of the knee: a randomized, sham-controlled pilot study.J Altern Complement Med. 2008; 14: 1075-1081Crossref PubMed Scopus (16) Google Scholar. Lastly, it is worth mentioning that from the description of TENS intervention by Itoh et al.10Itoh K. Hirota S. Katsumi Y. Ochi H. Kitakoji H. A pilot study on using acupuncture and transcutaneous electrical nerve stimulation (TENS) to treat knee osteoarthritis (OA).Chin Med. 2008; 3: 2Crossref PubMed Scopus (34) Google Scholar, it was clear that interferential current stimulation was applied instead of it11Rutjes A.W. Nüesch E. Sterchi R. Kalichman L. Hendriks E. Osiri M. et al.Transcutaneous electrostimulation for osteoarthritis of the knee.Cochrane Database Syst Rev. 2009; 7: CD002823Google Scholar. Secondly, for the specific inclusion and exclusion criteria, one study12Laufer Y. Zilberman R. Porat R. Nahir A.M. Effect of pulsed short-wave diathermy on pain and function of subjects with osteoarthritis of the knee: a placebo-controlled double-blind clinical trial.Clin Rehabil. 2005; 19: 255-263Crossref PubMed Scopus (51) Google Scholar which examined the effects of pulsed shortwave diathermy in comparison with placebo treatment should have been included in this network meta-analysis. On the other hand, the authors stated that interventions which combined two or more physical treatments would be excluded. Nevertheless, this study actually included one trial13Burch F.X. Tarro J.N. Greenberg J.J. Carroll W.J. Evaluating the benefits of patterned stimulation in the treatment of osteoarthritis of the knee: a multi-center, randomized, single-blind, controlled study with an independent masked evaluator.Osteoarthritis Cartilage. 2008; 16: 865-872Abstract Full Text Full Text PDF PubMed Scopus (37) Google Scholar which investigated the benefits of the combination of interferential and patterned muscle stimulation compared with the low-current TENS. We have no idea whether these two studies will have an impact on the data analysis. Thirdly, as mentioned in the discussion section, the authors said their analysis represented the use of the most practical methods currently available, but they abandoned therapeutic ultrasound, which is absolutely one of the most frequently used physical therapies. Finally, unlike another network meta-analysis which was published in British Medical Journal recently14Uthman O.A. van der Windt D.A. Jordan J.L. Dziedzic K.S. Healey E.L. Peat G.M. et al.Exercise for lower limb osteoarthritis: systematic review incorporating trial sequential analysis and network meta-analysis.BMJ. 2013; 20 (f5555): 347Google Scholar, the authors only used the final pain values rather than the change scores from the baseline. Since many of the included studies were based on a small sample size, have the authors confirmed there were no significant baseline differences in pain scores between the treatment groups? Meanwhile, have the authors confirmed there was no trial conducted on patients with only mild pain before treatment? Our concern is that it is difficult to measure pain relief in the absence of pain. Above all, we respect the great contributions of the authors and we are pretty sure the results of the data analysis are accurate, and we would also be very interested in the authors' response to these comments and questions. All authors made substantial contributions to the interpretation, drafting, and revisions and approved the final version. The authors declare that they have no conflicts of interest. This work was supported by Hunan Provincial Innovation Foundation for Postgraduate, the Fundamental Research Funds for the Central Universities of Central South University, the National Natural Science Foundation of China (No. 81201420, 81272034), the Provincial Science Foundation of Hunan (No. 14JJ3032). Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysisOsteoarthritis and CartilageVol. 21Issue 9PreviewTo compare the effectiveness of acupuncture with other relevant physical treatments for alleviating pain due to knee osteoarthritis. Full-Text PDF Open AccessResponse to letter to the Editor: comment on Corbett et al. entitled “Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis”Osteoarthritis and CartilageVol. 22Issue 5PreviewWe thank Lei and colleagues for reading our systematic review in detail and for their letter which raised both general queries, and issues relating to specific trials in our review. We will address the general queries first. In stating that our analysis represented the use of the most practical methods currently available we were not referring to the types of intervention, but to our use of network meta-analysis methods (when faced with comparing such a large number of interventions); we excluded studies of ultrasound based on clinical advice which was given with specific regard to the UK setting (the review was commissioned with the UK setting in mind). Full-Text PDF Open Archive" @default.
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• W2159073054 title "Comment on Corbett et al. entitled “Acupuncture and other physical treatments for the relief of pain due to osteoarthritis of the knee: network meta-analysis”" @default.
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