Comparative Effectiveness of Acupotomy Versus Corticosteroid Injection, and Ultrasound-Guided Versus Blind Acupotomy for De Quervain Tenosynovitis

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Objectives To evaluate the clinical effectiveness of acupotomy compared to local corticosteroid injection for de Quervain tenosynovitis, and to determine whether ultrasound (US)-guided acupotomy provides superior outcomes over blind acupotomy.Methods We systematically searched multiple electronic databases for randomized controlled trials (RCTs).9 studies were identified and categorized into two groups: acupotomy versus local corticosteroid injection (group 1) and US-guided versus blind acupotomy (group 2).Data on total effective rate, visual analogue scale (VAS), and function were synthesized using meta-analysis with random-effects models.Risk of bias was assessed using the Cochrane tool to ensure the reliability of the findings.Results Analysis of 9 RCTs involving 614 patients showed that acupotomy achieved a significantly higher total effective rate than local corticosteroid injection (risk ratio 1.18; 95% confidence interval [CI], 1.08 to 1.30; p=0.0002,I 2 =0%).For group 2, US-guided acupotomy demonstrated significantly greater improvements in VAS (mean difference -0.99; 95% CI, -1.18 to -0.80; p<0.00001,I 2 =0%) compared to the blind procedure.Conclusions Acupotomy is an effective alternative to local corticosteroid injection for de Quervain tenosynovitis, and US guidance significantly optimizes clinical outcomes by enhancing procedural precision.These findings support the use of US-guided acupotomy as a primary conservative treatment option.(

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