Brian M. Berman, MD; Lixing Lao, PhD; Patricia Langenberg, PhD; Wen Lin Lee, PhD; Adele M.K. Gilpin, PhD; Marc C. Hochberg, MD
Acknowledgments: The authors thank Mary Bahr, study coordinator; Jody Boone, arthritis educator; Marcos Hsu, ND, LAc, acupuncturist; Michelle Sittig and Deborah Taber, research assistants; Danuta Bujak, RN, CRNP, PhD, nurse practitioner; and Amy Martin Burns, administrative assistant, for their contributions.
Grant Support: By the National Center for Complementary and Alternative Medicine (National Institutes of Health Cooperative Agreement U01 AT-00171), with advice and encouragement by the National Institute of Arthritis and Musculoskeletal and Skin Diseases.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Brian Berman, MD, Center for Integrative Medicine, University of Maryland School of Medicine, 2200 Kernan Drive, Baltimore, MD 21207.
Current Author Addresses: Drs. Berman, Lao, Lee, and Gilpin: Center for Integrative Medicine, University of Maryland School of Medicine, 2200 Kernan Drive, Baltimore, MD 21207.
Dr. Langenberg: EPM Gender Based, 102 A, HH, University of Maryland School of Medicine, 660 West Redwood Street, Baltimore, MD 21201.
Dr. Hochberg: University of Maryland School of Medicine, 10 South Pine Street, MSTF 834, Baltimore, MD 21201.
Author Contributions: Conception and design: B. Berman, L. Lao, P. Langenberg, M.C. Hochberg.
Analysis and interpretation of the data: B. Berman, P. Langenberg, W.L. Lee, A.M.K. Gilpin, M.C. Hochberg.
Drafting of the article: B. Berman, L. Lao, P. Langenberg.
Critical revision of the article for important intellectual content: B. Berman, L. Lao, P. Langenberg, A.M.K. Gilpin, M.C. Hochberg.
Final approval of the article: B. Berman, L. Lao, P. Langenberg, W.L. Lee, A.M.K. Gilpin, M.C. Hochberg.
Statistical expertise: P. Langenberg.
Obtaining of funding: B. Berman, L. Lao.
Administrative, technical, or logistic support: L. Lao.
Collection and assembly of data: W.L. Lee.
Berman BM, Lao L, Langenberg P, Lee WL, Gilpin AM, Hochberg MC. Effectiveness of Acupuncture as Adjunctive Therapy in Osteoarthritis of the Knee: A Randomized, Controlled Trial. Ann Intern Med. 2004;141:901-910. doi: 10.7326/0003-4819-141-12-200412210-00006
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Published: Ann Intern Med. 2004;141(12):901-910.
Osteoarthritis is the most common form of arthritis and is a major cause of morbidity, limitation of activity, and health care utilization, especially in elderly patients (1, 2). Pain and functional limitation are the primary clinical manifestations of osteoarthritis of the knee. Current recommendations for managing osteoarthritis, including guidelines published by the American College of Rheumatology (3) and European League of Associations of Rheumatology (4), focus on relieving pain and stiffness and maintaining or improving physical function as important goals of therapy. No curative therapies exist for osteoarthritis; thus, both pharmacologic and nonpharmacologic management focus on controlling pain and reducing functional limitation (5). Nonpharmacologic therapy, which includes patient education, social support, physical and occupational therapy, aerobic and resistive exercises, and weight loss, is the cornerstone of a multidisciplinary approach to osteoarthritis patient management (3). Pharmacologic therapies include nonopioid analgesics (such as acetaminophen), nonsteroidal anti-inflammatory drugs (NSAIDs) (including cyclooxygenase-2 [COX-2] enzyme selective inhibitors), topical analgesics (capsaicin cream), opioid analgesics, and intra-articular steroid and hyaluronate injections. Often, these agents are used in combination for additive analgesic efficacy (6). Pharmacologic management of osteoarthritis is often ineffective, and agents such as NSAIDs may cause unwanted and dangerous side effects (7, 8).
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Rheumatology, Osteoarthritis, Prevention/Screening.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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