ELECTROACUPUNCTURE AS A NON-PHARMACOLOGIC ADJUNCT FOR POSTOPERATIVE RECOVERY FOLLOWING TOTAL KNEE ARTHROPLASTY: A SYSTEMATIC REVIEW AND META-ANALYSIS
Author(s)
Jihye Kim, PhD1, Lin Ang, PhD2, Sunmi CHOI, Ph.D.1.
1Korea Institute of Oriental Medicine, Daejeon, Korea, Republic of, 2Gachon University, Seongnam-si, Korea, Republic of.
1Korea Institute of Oriental Medicine, Daejeon, Korea, Republic of, 2Gachon University, Seongnam-si, Korea, Republic of.
OBJECTIVES: Postoperative pain following total knee arthroplasty (TKA) contributes substantially to analgesic utilization, delayed functional recovery, and rehabilitation burden. Electroacupuncture (EA) has emerged as a potential non-pharmacologic adjunctive strategy within multimodal postoperative care pathways. This study evaluated the effectiveness and implementation-relevant outcomes of EA following TKA.
METHODS: A systematic review and meta-analysis of randomized controlled trials was conducted across 13 electronic databases. Studies evaluating EA following TKA were included. Primary outcomes included postoperative pain intensity. Secondary outcomes included range of motion (ROM), recovery-related outcomes, and adverse events. Risk of bias was assessed using the Cochrane RoB 2 tool. Random-effects meta-analyses were performed using standardized mean differences (SMDs) and 95% confidence intervals (CIs).
RESULTS: Fifteen randomized controlled trials involving 1,318 patients were included. Compared with sham electroacupuncture, EA demonstrated significant reductions in postoperative pain at post-intervention (n=413; SMD -0.99; 95% CI -1.78 to -0.21). EA combined with rehabilitation exercise also showed greater pain reduction versus rehabilitation alone (n=262; SMD -1.22; 95% CI -1.51 to -0.92). Improvements in ROM and functional recovery outcomes were reported in several studies. Reported adverse events were minimal, suggesting a favorable safety profile. However, methodological concerns including inadequate blinding and inconsistent reporting reduced overall certainty of evidence.
CONCLUSIONS: EA may represent a promising non-pharmacologic adjunctive intervention for postoperative pain management and rehabilitation following TKA. The observed improvements in pain and functional recovery outcomes suggest potential relevance for value-based postoperative care pathways and opioid-sparing rehabilitation strategies. Higher-quality trials incorporating healthcare utilization, patient-reported outcomes, and cost-related endpoints are needed to support evidence-informed implementation decisions.
METHODS: A systematic review and meta-analysis of randomized controlled trials was conducted across 13 electronic databases. Studies evaluating EA following TKA were included. Primary outcomes included postoperative pain intensity. Secondary outcomes included range of motion (ROM), recovery-related outcomes, and adverse events. Risk of bias was assessed using the Cochrane RoB 2 tool. Random-effects meta-analyses were performed using standardized mean differences (SMDs) and 95% confidence intervals (CIs).
RESULTS: Fifteen randomized controlled trials involving 1,318 patients were included. Compared with sham electroacupuncture, EA demonstrated significant reductions in postoperative pain at post-intervention (n=413; SMD -0.99; 95% CI -1.78 to -0.21). EA combined with rehabilitation exercise also showed greater pain reduction versus rehabilitation alone (n=262; SMD -1.22; 95% CI -1.51 to -0.92). Improvements in ROM and functional recovery outcomes were reported in several studies. Reported adverse events were minimal, suggesting a favorable safety profile. However, methodological concerns including inadequate blinding and inconsistent reporting reduced overall certainty of evidence.
CONCLUSIONS: EA may represent a promising non-pharmacologic adjunctive intervention for postoperative pain management and rehabilitation following TKA. The observed improvements in pain and functional recovery outcomes suggest potential relevance for value-based postoperative care pathways and opioid-sparing rehabilitation strategies. Higher-quality trials incorporating healthcare utilization, patient-reported outcomes, and cost-related endpoints are needed to support evidence-informed implementation decisions.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
CO111
Topic
Clinical Outcomes, Patient-Centered Research, Study Approaches
Topic Subcategory
Clinician Reported Outcomes, Comparative Effectiveness or Efficacy
Disease
Musculoskeletal Disorders (Arthritis, Bone Disorders, Osteoporosis, Other Musculoskeletal)