Moxibustion for Knee Osteoarthritis
Condition: Idiopathic Osteoarthritis
MeSH terms: Osteoarthritis; Osteoarthritis, Knee
Study type: Interventional
Phase: Phase 1/Phase 2

Summary: 
      This study aims to assess the feasibility, effectiveness and safety of moxibustion for
      symptom management and function improvement in patients with knee osteoarthritis, compared to
      usual care group.
    

Detailed description: 
      Knee osteoarthritis (OA) is a common joint disease and a leading cause of pain and physical
      disability in older people. Its symptoms, including pain and physical disability,
      significantly affect patient's quality of life, and increased depression has been observed in
      patients with greater pain due to knee OA. Current management options include exercise,
      weight reduction, Non-steroidal anti-inflammatory drugs (NSAIDs) and other pain medication,
      intra-articular injections of steroid or hyaluronan, arthroscopic surgery and joint
      replacement. Except exercise and weight reduction, no known interventions have shown
      definitive evidence of benefits and safety for knee OA. Thus, it is still worth exploring
      effective and safe management options for knee OA patients.

      Moxibustion is one of traditional Asian medicine using the heat stimulation by burning
      mugwort (mainly Artemisia vulgaris or Artemisia argyi) on acupuncture points, and regarded as
      a subtype of acupuncture. Previous literatures reported its use on chronic conditions
      including gastrointestinal disease, hypertension, musculoskeletal pain, cancer care,
      gynecological conditions and stroke rehabilitation solely or in combination with routine care
      or other traditional medicine. However, studies adequately evaluating effects and safety of
      moxibustion for patients with knee OA are insufficient. Given the gaps between little
      evidence for effects and safety of moxibustion for knee osteoarthritis and its wide use in
      clinical practice, the investigators attempted to assess the feasibility, effectiveness and
      safety of moxibustion for patients with knee osteoarthritis.
    

Intervention name(s): Moxibustion treatment plus usual care; Usual care alone group
Intervention type(s): Other; Other
Intervention description(s): Treatment group received moxibustion treatment three times a week for 4 consecutive weeks, totally 12 sessions of treatment in addition to usual care to manage their knee OA.
Moxibustion points include six local acupuncture points on affected knee joint. Up to two additional tender points will be allowed, if necessary. If participants feel knee pain on both knee joints, study practitioners will provide treatment on both knee.
We will use smokeless indirect moxibustion made of wormwood with a diameter of 1.9 centirmeter and a length of 2.1 centimeter in a cylindrical form for this study (Haitnim Bosung Inc, Korea). Free participant-practitioner interaction will be allowed during the treatment session. Expected total time of each treatment session will be 40 - 60 minutes.; Usual care alone group can receive or use any kind of treatment other than moxibustion treatment provided as study intervention, which includes surgery, conventional medication, physical treatment, acupuncture, herbal medicine, over-the-counter drugs and other active treatment. This also applies to the moxibustion treatment group.
Education material of information on knee osteoarthritis and current management option and self-exercise sheet with a yoga-mat to enhance regular exercise will be provided in both groups at baseline.
Other intervention name(s): Smokeless indirect moxibustion produced by Haitnim Bosung Inc, Korea.
Intervention MeSH terms: Lobeline
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: knee osteoarthritis