09 February 2026 : Meta-Analysis
Efficacy and Safety of Electroacupuncture for Pain Alleviation in Post-Total Knee Arthroplasty Patients: A Systematic Review and Meta-Analysis
Hao Wang AB 1, Wenjie Chen DF 1, Guangyou Chen AB 1*, Kai Zhu D 1, Kaiquan Zhang BC 1, Dongdong Li F 1, Yang Lei B 1DOI: 10.12659/MSM.951091
Med Sci Monit 2026; 32:e951091
Table 4 Overall evidence GRADE quality rating of 16 included studies.
| Quality assessment | Sample size | Outcomes measures | Quality | Importance | ||||||
|---|---|---|---|---|---|---|---|---|---|---|
| Number of RCT | Risk of bias | Inconsistency | Indirectness | Imprecision | Publication bias | EA group | Control group | |||
| VAS at rest (on postoperative day 1) 9 | Serious limitations | No serious indirectness | No serious indirectness | No serious indirectness | No serious indirectness | 314 | 314 | MD=−0.49, 95% CI=−0.62 to −0.35, P<0.00001 | Middle | Critical |
| VAS at rest (on postoperative day 3) 12 | Serious limitations | Serious limitations | No serious indirectness | No serious indirectness | No serious indirectness | 378 | 379 | MD=−0.89, 95% CI=−1.11 to −0.68, P<0.00001 | Low | Critical |
| VAS at rest (on postoperative day 7) 11 | Serious limitations | Serious limitations | No serious indirectness | No serious indirectness | Serious limitations | 294 | 293 | MD=−0.51, 95% CI=−0.65 to −0.38, P<0.00001 | Very low | Critical |
| VAS at motion (on postoperative day 1) 6 | Serious limitations | No serious indirectness | No serious indirectness | No serious indirectness | No serious indirectness | 165 | 165 | MD=−0.54, 95% CI=−0.76 to −0.33, P<0.00001 | Middle | Critical |
| VAS at motion (on postoperative day 3) 6 | Serious limitations | No serious indirectness | No serious indirectness | No serious indirectness | No serious indirectness | 145 | 145 | MD=−0.56, 95% CI=−0.69 to −0.42, P<0.00001 | Middle | Critical |
| VAS at motion (on postoperative day 7) 6 | Serious limitations | No serious indirectness | No serious indirectness | No serious indirectness | No serious indirectness | 145 | 145 | MD=−0.57, 95% CI=−0.69 to −0.44, P<0.00001 | Middle | Critical |
| PGE-2 level 3 | Serious limitations | No serious indirectness | No serious indirectness | No serious indirectness | No serious indirectness | 85 | 85 | MD=−33.15, 95% CI=−37.29 to 29.01, P<0.00001 | Middle | Critical |
| β-endorphins level 3 | Serious limitations | Serious limitations | No serious indirectness | No serious indirectness | No serious indirectness | 85 | 85 | MD=54.75, 95% CI=47.08 to 62.42, P<0.00001 | Low | Critical |
| The number of additional use of analgesics 4 | Serious limitations | No serious indirectness | No serious indirectness | No serious indirectness | No serious indirectness | 125 | 125 | RR=0.46, 95% CI=0.25 to 0.85, P<0.00001 | Middle | Critical |
| Adverse effect 9 | Serious limitations | No serious indirectness | No serious indirectness | No serious indirectness | V | 291 | 292 | RR=0.45, 95% CI=0.27 to 0.75, P=0.002 | Middle | Critical |
| VAS – visual assessment scale; MD – mean difference; EA – electroacupuncture; RR – risk ratio; CI – confidence interval. | ||||||||||