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There is a possibility that the effect of acupuncture for knee osteoarthritis may be underestimated. Based on the difference in effect derived from this network meta-analysis, it will be necessary to directly compare whether there is an effect difference between acupuncture in real-world clinical practice and that in a sham device-controlled trial.

Additionally, pragmatic trials of acupuncture for knee osteoarthritis compared to usual care would help to clarify the potential benefit to patients in real-world clinical settings.

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Front. Med. 9:1061878. doi: 10.3389/fmed.2022.1061878

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