• Tom Petersen, Holger Hautopp, Benn Duus, and Carsten Juhl.
• Section for Orthopaedic and Sports Rehabilitation, Health Centre Nørrebro, Copenhagen N, Denmark.
• Pain Med. 2018 Jun 1; 19 (6): 1280-1289.

ObjectiveAcupuncture is a low risk option in pain management following total knee replacement as an alternative to opioid analgesics. Therefore, the benefit of acupuncture as adjunct to an exercise program was investigated. Furthermore, the modifying effect of previous benefit from acupuncture was explored.DesignThree weeks postoperatively, eligible patients were randomized to acupuncture and exercises or exercises alone.SettingAn outpatient rehabilitation centre in the municipality of Copenhagen, Denmark.SubjectsA total of 172 patients were included.MethodsMain outcome was proportion of patients that reported a clinically important change in pain at night following each treatment. Secondary outcomes were change in disability measured after termination of the course of treatment and at three months follow-up. Also consumption of medication and walking distance after termination of the course of treatment were assessed.ResultsNo additional benefit of acupuncture was found on any of the main outcomes. Between-group differences were non-significant in proportions of patients with a clinically important reduction of night pain (Relative Risk: 0.98; 95% Confidence Interval (CI): 0.86-1.11) or evening pain (Relative Risk: 0.94; 95% CI: 0.81-1.0.ConclusionsOur results do not support the addition of acupuncture to routine rehabilitation. Previous benefit from acupuncture was not able to identify those likely to respond to acupuncture. Future studies to investigate whether subgroups of patients would benefit from acupuncture are needed.

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