| Summary: | Objectives: This study aims to evaluate the efficacy of Fu's subcutaneous needling (FSN) for knee osteoarthritis (KOA) via a meta-analysis. Methods: Randomized controlled trials (RCTs) of FSN for KOA were searched in PubMed, Cochrane Library, Embase, Web of Science, and other databases up to July 20, 2024. Stata 15.0 was leveraged for data analysis. Results: 30 RCTs were included, involving 2169 individuals. Compared to electroacupuncture, acupuncture, and other therapies, FSN demonstrated significant benefits in reducing the Western Ontario and McMaster Universities Arthritis Index score (WOMAC, improved physical function) [SMD= -1.69 (-2.15 to −1.23), I² = 89.8 %, P < 0.001] and relieving pain (the visual analog scale) [SMD = -1.77( −2.14 to −1.40); I² = 89.8 %, P < 0.001]. Additionally, FSN was more effective in reducing inflammatory cytokine levels, such as interleukin 1β [SMD = -1.65 (-2.36, −0.94); I² = 91.9 %, P < 0.001], interleukin-6 [SMD = -3.93 (-5.08, −2.78); I² = 96.7 %, P < 0.001], and tumor necrosis factor-α [SMD = -2.65 (-3.46, −1.83); I² = 94.8 %, P < 0.001], and increasing the total effective rate [OR = 4.17, 95 % CI: 3.05–5.68; I² = 0.0 %, P < 0.001]. Conclusions: FSN shows promise as an adjuvant therapy for KOA, with moderate-quality evidence supporting its short-term efficacy in pain relief and functional improvement. Further validation through standardized protocols is required to determine its long-term benefits.
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