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20-08-2012 | General practice | Article

Acupuncture ‘could save knee ops’



medwireNews: Nurse-led group acupuncture clinics for patients with knee osteoarthritis offer a cost-effective alternative to surgery, say researchers.

The approach could save commissioning groups £100,000 a year, claims the team.

Having previously offered NHS acupuncture services, in 2008 St Albans and Harpenden practice-based commissioning group set up two acupuncture clinics specifically for knee pain, with nurses providing the treatment to groups of patients to save costs.

In the first year of operation, 90 (79%) out of a total of 114 patients with a clinical or radiological diagnosis of osteoarthritis accepted the offer of acupuncture rather than direct referral to an orthopaedic surgeon.

After 1 year, 41 (46%) patients were still attending, while 31 (34%) were still doing so at 2 years of follow-up, by which time they had received 27 treatments each, report study authors Dr Adrian White (Plymouth University) and colleagues in Acupuncture in Medicine. Patients had clinically significant improvements in knee pain and functional capacity measures at 1 month, which were sustained at 6-monthly assessments up to 2 years.

Patients' well-being did not change, however, and the authors concede that overall the data are "somewhat limited by the smaller number of responses". Also, they note that over time GPs began referring patients who did not want or were not fit for surgery, meaning some patients who did not fit the usual criteria were included.

Despite the concern that patients may deteriorate if surgery is delayed, the researchers conclude that their study "shows the practicability of offering a low-cost acupuncture service as an alternative to knee surgery and its success in achieving long-term symptom relief in about a third of patients".

In a related study published in the same journal, Dr Anthea Asprey (University of Exeter) and team report that participants in group acupuncture were generally accepting of the approach. They suggest that the group environment "could encourage new patients to persist with acupuncture treatment".

medwireNews ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2012

By Caroline Price