| Osteoarthritis(OA)is a disease characterized by progressive degeneration of joint cartilage,synovitis,and subchondral bone remodeling.It can lead to joint pain and stiffness,and it affects a common function of daily life.Chronic joint disease.Knee osteoarthritis(KOA)is the most common OA,and its quality of life is degraded due to severe pain and dysfunction.Pulsed electromagnetic fields(PEMF)as a safe,non-invasive and simple treatment method has been widely used in the treatment of osteoporosis,fractures and nonunion,and osteoarthritis.However,the efficacy of PEMF in the treatment of knee osteoarthritis has been a major controversy.Objective To investigate the efficacy of pulsed electromagnetic field in the treatment of knee osteoarthritis using meta-analysis and to provide evidence-based medical evidence for pulsed electromagnetic fields in the treatment of knee osteoarthritis.Methods applied Cochrane systematic evaluation method,computer search Or manually search the foreign language databases Cochrane Library,Pub Med,Embase,Ovid,Medline,Science Direct,and search the Chinese database How Net,Wanfang,Weipu,and China MedicalLiterature Database(dates are 1993 from December 31,2017).All randomized controlled literature of pulsed electromagnetic fields for the treatment of knee osteoarthritis was screened according to inclusion and exclusion criteria.According to the Cochmne Collaboration recommended "risk assessment tool" for literature bias risk assessment.Knee pain,WOMAC stiffness,WOMAC daily life ability and WOMAC scores were the main analysis indicators.Evaluate the efficacy of pulsed electromagnetic field in the treatment of knee osteoarthritis by comparing before and after treatment;analyze the effect of pulsed electromagnetic fields with different frequencies on the pain of knee osteoarthritis;analyze the effect of different treatment durations on the frequency of lowfrequency pulsed electromagnetic fields on knee osteoarthritis pain Influence;pulsed electromagnetic field as the treatment group,sham treatment group as the control group,the effect of pulsed electromagnetic field on knee osteoarthritis was analyzed;Rev Man 5.1 software was used for statistical analysis.For continuous variables,standardised mean difference(SMD)was used as the effect statistic.Results A total of 13 randomized controlled trials were included.A total of 693 patients were included,including 381 in the pulsed electromagnetic field group and 312 in the placebo group.The statistical results showed that the pulsed electromagnetic field before and after knee osteoarthritis was statistically significant in relieving pain(SMD=0.82,95%CI(0.48,1.15),P4 weeks There was also a statistical difference between ?8 weeks(SMD=0.80,95%CI(0.53,1.07),P8 weeks and ?12weeks.{SMD = 0.67,95% CI(0.51,0.82),P < 0.05}.The results suggest that the use of low-frequency electromagnetic field therapy within 12 weeks is significant for the relief of knee osteoarthritis pain.Using lowfrequency electromagnetic field therapy,there was a statistically significant difference in relieving joint stiffness {SMD=0.46,95%CI(0.26,0.66),P< 0.05}.There was a statistical difference between the pulsed electromagnetic fields before and after WOMAC scores{SMD=0,59,95%CI(0.12,1.06),P=0.01}.In a randomized controlled study of pulsed electromagnetic field and sham group,the pulsed electromagnetic fields were used to treat knees.Joint osteoarthritis suggested high heterogeneity in the relief of pain I2 = 90%,{SMD =-0.65,95% CI(-1.16,-0.13),P < 0.05}.In the control study of knee osteoarthritis with different frequency pulsed electromagnetic fields,there was no significant difference between the pulsed electromagnetic field and placebo group in improving the joint pain in the frequency ?50Hz group {SMD=-0.05,95%CI(-0.29,0.20),P=0.70}.The frequency of100Hz-145 Hz group,pulsed electromagnetic field and sham treatment group,no significant difference in the improvement of joint pain {SMD =-0.50,95% CI(-1.36,0.36),P = 0.26}.The frequency of6.8MHz-27.12 MHz group,compared with the sham group,there was also a high heterogeneity of I2=83% after the treatment,{SMD=-1.28,95%CI(-2.52,-0.05),P=0.04}.The credibility of the evidence is low.Low-frequency pulsed electromagnetic fields(frequency ?100Hz)were not statistically different from the sham group when the treatment time was ?4 weeks {SMD=-0.09,95%CI(-0.40,0.22),P=0.57},during treatment time There was no statistical difference between the 4 weeks and 8 weeks(SMD =-0.91,95% CI(-2.30,0.48),P = 0.20).There was no statistical difference between the treatment time> 8 weeks and ? 12 weeks.{SMD=-0.24,95% CI(-0.54,0.06),P=0.12}.There was no statistical difference in relieving joint stiffness {SMD=-0.05,95%CI(-0.27,0.18),P=0.67},and there was no statistical difference in improving daily living ability.{SMD=-0.11,95%CI(-0.33,0.12),P=0.36}.There was also no statistical difference between the two groups on the WOMAC score(SMD =-0.02,95% CI(-0.29,0.24),P = 0.86).Conclusions The use of pulsed electromagnetic field therapy in the treatment of knee osteoarthritis has a certain effect,and its effect is equivalent to sham treatment. |
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