Traditional Korean Medicine as Collaborating Treatments with Conventional Treatments for Knee Osteoarthritis: A Protocol for a Systematic Review and Meta-Analysis

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Yeon-Cheol Park,1,* Bon-Hyuk Goo,2,* Kyeong-Ju Park,3 Jun-Yeon Kim,3 Yong-Hyeon Baek1 1Department of Acupuncture & Moxibustion, College of Korean Medicine, Kyung Hee University, Seoul, 02447, South Korea; 2Department of Acupuncture & Moxibustion, Kyung Hee University Hospital at Gangdong, Seoul, 05278, South Korea; 3Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Seoul, 02447, South Korea*These authors contributed equally to this workCorrespondence: Yong-Hyeon BaekDepartment of Acupuncture & Moxibustion, College of Korean Medicine, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, South KoreaTel +82 02 440 8642Fax +82 02 440 7770Email byhacu@khu.ac.krBackground: Knee osteoarthritis (OA) is a degenerative disease of the joint cartilage with no definite treatment in the early stage. Several previous review studies have shown that alternative medical treatments, including acupuncture, moxibustion, and herbal medicines, are effective in improving the symptoms of the disease and the patient’s quality of life. However, no systematic review study has shown the effectiveness of the combination of conventional and alternative therapies. Therefore, the aim of our study is to determine the most effective combination therapies and to provide evidence for the effectiveness and safety of integrated therapies. This article describes the protocol for the methods that will be applied in our systematic review.Methods: We will conduct an electronic search of nine databases: PubMed, Embase, Cochrane, Google Scholar (first 100 articles), four Korean databases (KoreaMed, Korean Studies Information Service System, Research Information Service System, and Oriental Medicine Advanced Searching Integrated System), and one Chinese database (China National Knowledge Infrastructure). Only randomized controlled studies that reported on both conventional treatment (drugs and hyaluronic acid) and traditional Korean medicine (acupuncture, moxibustion, and herbal medicines) will be selected. The primary outcomes will be pain and function of the joint. The secondary outcomes will include pain relief duration, total effective rate, incidence of adverse events, and quality of life. We will assess the methodological quality of the included studies using the Cochrane risk of bias tool. For the meta-analysis, standardized mean differences and risk ratios with 95% confidence intervals will be applied for continuous and dichotomous data, respectively.Results: This review will evaluate the effectiveness and safety of several Korean medicine treatments combined with conventional treatments for knee OA.Conclusion: Our review will provide a good foundation for the integrative treatment of knee OA.Keywords: acupuncture, herbal medicine, hyaluronic acid injection, knee osteoarthritis, moxibustion, NSAIDs

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