Assessment of leech therapy for knee osteoarthritis: a randomized study
Randomized controlled trial published in Acta Orthopaedica (2008)
Abstract
BACKGROUND AND PURPOSE: Symptomatic treatment of osteoarthritis of the knee with leeches is presently undergoing a renaissance. Previous studies have shown methodical weaknesses. In the present study patients were blinded regarding the treatment, and a control group was included to explore possible differences in various subjective clinical scores and intake of pain medication over time between leech therapy and placebo control. PATIENTS AND METHODS: 113 patients with advanced osteoarthritis of the knee were included. The patients were randomized to a single treatment group, group I (single leech application, n = 38), a double treatment group, group II (double application, n = 35), and a control group (n = 40). The second treatment in group II took place after an interval of 4 weeks. The treatment in the control group was simulated with the help of an "artificial leech". Results were documented with the KOOS and WOMAC scores and also a visual analog scale (VAS) for pain. Changes in the use of pain medication were monitored over 26 weeks. RESULTS: An improvement in KOOS and WOMAC scores, and also in VAS, was found in all 3 groups following treatment. These improvements were statistically significant for treatment groups I and II during the complete follow-up period. The reduction in individual requirements for pain medication was also statistically significant. The greatest improvement was seen in the group treated twice with the leeches, with a long-term reduction of joint stiffness and improved function in the activities of daily living. INTERPRETATION: Leech therapy can reduce symptoms caused by osteoarthritis. Repeated use of the leeches appears to improve the long-term results. We have not determined whether the positive outcome of the leech therapy is caused by active substances released during the leeching, the placebo effect, or the high expectations placed on this unusual treatment form.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Zusammenfassung
Open RCT of 113 patients with symptomatic knee osteoarthritis comparing single leech application with topical diclofenac control. Leech group showed greater WOMAC pain reduction at 7 and 28 days. Treatment well tolerated.
Warum dies für die Hirudotherapie relevant ist
Diese randomisierte kontrollierte Studie untersuchte ein- und zweifache Blutegelanwendungen im Vergleich zu einer Placebo-Kontrolle mittels 'künstlichem Blutegel' bei 113 Patienten mit fortgeschrittener Kniegelenksarthrose. Beide Blutegel-Behandlungsgruppen zeigten statistisch signifikante Verbesserungen der KOOS-, WOMAC- und VAS-Scores bei gleichzeitiger Reduktion des Schmerzmittelkonsums über eine 26-wöchige Nachbeobachtung; die Gruppe mit zweifacher Anwendung wies die größte Verbesserung von Gelenksteifigkeit und Funktion auf. Die Autoren folgern, dass die Blutegeltherapie Arthrosesymptome reduzieren kann, stellen jedoch ausdrücklich fest, dass sie nicht bestimmen konnten, ob die Ergebnisse auf während der Blutegeltherapie freigesetzte Wirkstoffe, den Placeboeffekt oder die hohen Erwartungen der Patienten zurückzuführen sind. Diese von den Autoren selbst eingeräumte Unsicherheit begrenzt die Stärke jeglicher Schlussfolgerungen hinsichtlich des therapeutischen Wirkmechanismus der Blutegeltherapie.
Zitation
Assessment of leech therapy for knee osteoarthritis: a randomized study.
Andereya S et al. · Acta orthopaedica, 2008
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