Electrical acupoint stimulation (EAS) is proposed as a potentially beneficial treatment for patients suffering from knee osteoarthritis (KOA). This systematic review and meta-analysis aims to assess the assess the effectiveness and safety of EAS for KOA. To identify eligible RCTs, a systematic search for eligible RCTs is conducted through 6 November 2024 in 12 electronic literature databases, utilizing relevant keywords. The analysis applies a random-effects model to compute RRs and 95% CIs for the dichotomous outcome, alongside the SMD and 95% CIs for continuous outcomes. This meta-analysis includes 63 RCTs with a total of 6475 participants. The pooled analysis reveals that EAS increases the overall response rate by 19.5% (RR: 1.195, 95% CI: 1.130 to 1.264, P < 0.001; low certainty). For continuous outcomes, EAS produces large effects on WOMAC total score (SMD = -1.72, 95% CI -2.19 to -1.24; P < 0.001; low certainty), VAS score (SMD = -1.92, 95% CI -2.44 to -1.39; P < 0.001; very low certainty), WOMAC stiffness (SMD = -1.12, 95% CI -1.65 to -0.59; P < 0.001; low certainty) and Lysholm score (SMD = 1.10, 95% CI 0.47 to 1.73; P = 0.001; low certainty). It yields medium effects on WOMAC pain (SMD = -0.74, 95% CI -1.10 to -0.37; P < 0.001; low certainty), Lequesne index (SMD = -0.70, 95% CI -0.97 to -0.42; P < 0.001; low certainty) and WOMAC function (SMD = -0.51, 95% CI -0.97 to -0.05; P = 0.03; low certainty). There are no significant effects on peak quadriceps torque (SMD = 0.21, 95% CI -0.42 to 0.83; P = 0.518; low certainty) or knee range of motion (SMD = 0.66, 95% CI -0.07 to 1.38; P = 0.077; low certainty). Trial sequential analysis indicates that the required information size is met. This review suggests that EAS may be an effective and relatively safe adjunctive option for KOA; however, the certainty of the evidence is low due to substantial heterogeneity and potential biases. Higher-quality, rigorously designed RCTs with standardized reporting are needed to confirm these findings.
Copyright: © 2025 Yang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.