Table 2.
Summary of evidence.
| Author, year (country) | Outcomes | Studies (participants) | Relative effect (95% CI) | Heterogeneity |
|---|---|---|---|---|
| (a) (CLE/C vs placebo) | ||||
| Raveendhara R. 2018 (USA) [26] | Pain | 5 (331) | SMD: −0.81 (−1.25, −0.37)∗ | I2 = 71% |
| Function | 3 (232) | SMD: −0.48 (−0.74, −0.22)∗ | I2 = 0% | |
| The use of rescue drugs | 3 (141) | RR: 0.65(0.48, 1.05) | I2 = 74% | |
| Incidence of withdrawal from treatment due to adverse events | 4 (288) | RR: 0.90 (0.21, 3.79) | I2 = 14% | |
| Adverse events | 3 (247) | RR: 2.22 (0.94, 5.26) | I2 = 0% | |
| James W. Daily 2016 (South Korea) [34] | VAS | 3 (104) | MD: −2.04 (−2.85, −1.24)∗ | I2 = 27% |
| WOMAC scale | 3 (122) | MD: −15.36 (−26.9, −3.77)∗ | I2 = 91% | |
| An-Fang Hsiao 2021 (China) [28] | VAS | 7 (501) | SMD: −2.073 (−4.339, 0.194) | I2 = 96.6% |
| Adverse events | 6 (527) | Or: 1.115 (0.548, 2.271) | I2 = 0% | |
| Igho J. ONAKPOYA 2017 (UK) [32] | VAS | 5 (366) | SMD: −3.30(−4.99,−2.01)∗ | I2 = 97% |
| WOMAC scale | 3 (167) | SMD: −4.42 (−6.66, −2.19)∗ | I2 = 93% | |
| LPFI | 2 (107) | MD: −2.69 (−3.48,−1.90)∗ | I2 = 0% | |
| Zhiqiang Wang 2021 (Australia) [33] | Pain | 12 (1,071) | SMD = −0.82 (−1.17, −0.47)∗ | I2 = 86.23% |
| Function | 10 (973) | SMD = −0.75 (−1.18, −0.33)∗ | I2 = 90.05% | |
| Adverse events | 8 (791) | RD: 0.00 (−0.06,0.06) | I2 = 31.85% | |
| The use of rescue drugs | 7 (300) | RD: −0.13 (−0.24,−0.01)∗ | I2 = 54.36% | |
| Analgesic discontinuation rate | 4 (154) | RD: 0.36 (0.1, 0.61)∗ | I2 = 87.06% | |
| Wenli Dai 2021 (China) [29] | VAS | 8 (569) | MD: −2.21 (−3.15, −1.28)∗ | I2 = 94% |
| WOMAC scale | 5 (377) | MD: −11.93 (−16.63, −7.23)∗ | I2 = 81% | |
| WOMAC (pain) scale | 5 (377) | MD: −1.94 (−2.80, −1.09)∗ | I2 = 76% | |
| WOMAC (physical) scale | 5 (377) | MD: −6.45 (−9.10,−3.80)∗ | I2 = 83% | |
| WOMAC (stiffness) scale | 5 (377) | MD: −0.53 (−0.95, −0.11)∗ | I2 = 77% | |
| Adverse events | 7 (623) | RR: 1.08 (0.69, 1.70) | I2 = 19% | |
| Jian Wu 2019 (China) [30] | WOMAC scale | 3 (146) | SMD: −1.30 (−1.66, −0.94)∗ | I2 = 37% |
| VAS | 2 (98) | SMD: −1.65 (−2.11, −1.19)∗ | I2 = 0% | |
| Adverse events | 2 (113) | RR:1.46 (0.57, 3.77) | I2 = 0% | |
| Liuting Zeng 2021 (China) [31] | VAS | 6 (381) | MD: −11.55 (−14.3, −9.06)∗ | I2 = 69% |
| WOMAC (pain) scale | 4 (315) | SMD: −0.66 (−0.88, −0.43)∗ | I2 = 34% | |
| WOMAC (physical) scale | 4 (315) | SMD: −0.79 (−1.27, −0.31)∗ | I2 = 75% | |
| WOMAC (stiffness) scale | 4 (315) | SMD: −0.35 (−0.57, −0.12)∗ | I2 = 26% | |
| Adverse events | 6 (629) | RR: 1.18 (0.71, 1.94) | I2 = 25% | |
| Weiyan Gong 2017 (China) [27] | VAS | 2 (82) | SMD: −0.69 (−0.99, −0.40)∗ | I2 = 48.4% |
| WOMAC scale | 2 (82) | SMD: −1.44 (−1.91, −0.96)∗ | I2 = 0% | |
| Adverse events | 2 (152) | Or: 1.5 (0.65, 3.44) | I2 = 0% | |
| Walking distance | 1 (48) | MD: 202.0 (187.56, 216.44)∗ | NA | |
|
| ||||
| (b) (CLE/C vs CT) | ||||
| Raveendhara R. 2018 (USA) [26] | Pain (vs NSAIDs) | 2 (422) | SMD: −0.05 (−0.41, 0.31)∗ | I2 = 60% |
| Function (vs NSAIDs) | 1 (331) | SMD: −0.02 (−0.24, 0.19) | NA | |
| The use of rescue drugs (vs NSAIDs) | 2 (422) | RR 2.46 (0.48, 12.52) | I2 = 60% | |
| Incidence of withdrawal from treatment due to adverse events (vs NSAIDs) | 2 (474) | RR: 0.22 (0.05, 0.99)∗ | I2 = 0% | |
| Adverse events (vs NSAIDs) | 2 (467) | RR: 0.74 (0.60, 0.91)∗ | I2 = 0% | |
| James W. Daily 2016 (South Korea) [34] | WOMAC scale (vs painkillers) | 5 (625) | MD: −1.89 (−4.13,0.35) | I2 = 94% |
| An-Fang Hsiao 2021 (China) [28] | VAS (vs NSAIDs) | 2 (256) | SMD: −0.329 (−0.540, −0.117)∗ | I2 = 0% |
| Adverse events (vs NSAIDs) | 3 (623) | Or: 0.524 (0.121, 2.279) | I2 = 63.2% | |
| Igho J. ONAKPOYA 2017 (UK) [32] | WOMAC scale (vs NSAIDs) | 1 (331) | MD: −0.03 (−0.03, 0.09) | NA |
| Zhiqiang Wang 2021 (Australia) [33] | Pain (vs NSAIDs) | 5 (648) | SMD = −0.09 (−0.30, 0.12) | I2 = 34.97% |
| Function (vs NSAIDs) | 3 (477) | SMD = −0.14 (−0.36, 0.09) | I2 = 20.02% | |
| Adverse events (vs NSAIDs) | 3 (571) | RD: −0.12 (−0.24, −0.01)∗ | I2 = 42.74% | |
| The use of rescue drugs (vs NSAIDs) | 2 (443) | RD: 0.02 (−0.01, 0.04) | I2 = 0.01% | |
| Jian Wu 2019 (China) [30] | WOMAC scale (vs NSAIDs) | 1 (331) | SMD: −0.06 (−0.28, 0.15) | NA |
| Adverse events (vs NSAIDs) | 2 (159) | RR:0.81 (0.63, 1.05) | I2 = 0% | |
| Liuting Zeng 2021 (China) [31] | VAS (vs NSAIDs) | 2 (230) | MD: −0.34 (−1.25, 0.57) | I2 = 0% |
| WOMAC (pain) scale (vs NSAIDs) | 1 (331) | SMD: 0.04 (−0.18, 0.25) | NA | |
| WOMAC (physical) scale (vs NSAIDs) | 1 (331) | SMD: 0.07 (−0.14, 0.29) | NA | |
| WOMAC (stiffness) scale (vs NSAIDs) | 1 (331) | SMD: 0.07 (−0.17, 0.27) | NA | |
| Adverse events (vs NSAIDs) | 3 (561) | RR: 0.55 (0.34, 0.88)∗ | I2 = 70% | |
| Weiyan Gong 2017 (China) [27] | VAS (vs NSAIDs) | 1 (112) | MD: 13.00 (8.162,17.838)∗ | NA |
| WOMAC scale (vs NSAIDs) | 1 (331) | MD: 0.13 (−0.302, 0.562) | NA | |
| Walking distance (vs NSAIDs) | 2 (360) | MD: −1.17 (−19.7, 17.37) | I2 = 0% | |
| Adverse events (vs NSAIDs) | 3 (491) | Or: 0.55 (0.38, 0.81)∗ | I2 = 75.3% | |
Note. ∗The 95% confidence interval does not cross the invalid line.