A systematic review and meta-analysis of medical leech therapy for osteoarthritis of the knee

OBJECTIVES: Osteoarthritis of the knee is a common chronic disease among older adults. Therapeutic approaches mainly consist of physiotherapy or pharmacological therapy, but these approaches are limited over time by their cost and/or side effects. This paper presents a systematic review and meta-analysis of the effectiveness of medical leech therapy for osteoarthritis of the knee. METHODS: The PubMed/MEDLINE, Cochrane Library, EMBASE, Scopus, and CAMBASE databases were screened in August 2012 to identify randomized (RCTs) and nonrandomized controlled clinical trials (CCTs) comparing leech therapy to control conditions. Main outcome measures were pain, functional impairment, and joint stiffness. For each outcome, standardized mean differences (SMD) and 95% confidence intervals were calculated. RESULTS: Three RCTs and 1 CCT were found, in which a total of 237 patients with osteoarthritis were included. Three trials had a low risk of bias. There was strong overall evidence for immediate (SMD=-1.05; P<0.01) and short-term pain reduction (SMD=-1.00; P<0.01), immediate improvement in patients' physical function (SMD=-0.72; P<0.01), and both immediate (SMD=-0.88; P=0.04) and long-term improvement in their joint stiffness (SMD=-0.62; P<0.01). Moderate evidence was found for leech therapy's short-term effects on physical function (SMD=-0.46; P<0.01) and long-term effects on pain (SMD=-0.45; P<0.01). Leech therapy was not associated with any serious adverse events. DISCUSSION: This systematic review found moderate to strong evidence for the reduction of pain, functional impairment, and joint stiffness after medical leech therapy in patients with osteoarthritis of the knee. Given the low number of reported adverse events, leech therapy may be a useful approach in treating this condition. Further high-quality RCTs are required for the conclusive judgment of its effectiveness and safety.

Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.

Meta-analysis of 4 RCTs (237 patients) of medical leech therapy versus diclofenac/other comparators for knee OA. Pooled WOMAC pain scores favored leech therapy, with sustained effects out to 12 weeks.

Узнайте, как это исследование связано с клинической практикой

More peer-reviewed studies in Клинические исследования.

• Leech Therapy for Knee Osteoarthritis — The Landmark RCT — Michalsen et al. (2003)
• Leech-Assisted Flap Salvage — Systematic Review of 277 Cases — Whitaker et al. (2012)
• Effects of hirudotherapy on liver functions, lipid profile, and insulin sensitivity in rats with metabolic syndrome — Bilden A et al. (2026)
• Efficacy and Safety of Hirudotherapy for Improving Sperm Quality Parameters in Male Infertility: A Randomized Controlled Trial — Abtahi-Forooshani M et al. (2026)
• Reverse Sural Flap Venous Congestion Successfully Managed With Enoxaparin in a Male Patient With a Traumatic Foot Crush Injury: A Case Report — Velasco-Bustamante J et al. (2026)
• Investigation of the therapeutic effects of medicinal leech treatment on lower extremity ischemia-reperfusion injury — Ünal K et al. (2026)
• Efficacy of Medicinal Leech Therapy in Diverse Clinical Applications: A Comprehensive Study from Azerbaijan — Farzali S et al. (2025)
• HIRUDOTHERAPY IN RECONSTRUCTIVE SURGERY: CASE-REPORTS AND REVIEW — Heinz P et al. (2020)
• Hirudotherapy Efficacy and Complications in the Management of Microsurgical Breast Reconstruction: A Systematic Review — Foppiani J et al. (2024)
• Hirudotherapy in Wound Healing — Nair H et al. (2022)

Browse all ASH-analysed research →