This study was conducted to assess the safety and efficacy of oriental medicine (OM) treatments (encompassing acupuncture, herbal medicine, pharmacoacupuncture, and moxibustion) both as standalone therapies and in combination with conventional treatments for osteoarthritis of the knee. The study also sought to check the quality of evidence for these findings.

For systematically searching randomized controlled trials (RCTs) examining the impact of OM interventions, whether administered singly or in conjunction with conventional treatments, on  osteoarthritis of the knee, databases such as Google Scholar, Cochrane, Embase, PubMed, China National Knowledge Infrastructure, and four Korean medical databases (KoreaMed, Korean Studies Information Service System, Research Information Service System, and Oriental Medicine Advanced Searching Integrated System) were explored.

In this PRISMA-compliant systematic review and meta-analysis, the incorporated studies' risk of bias was determined utilizing the Cochrane Collaboration's risk of bias tool. Furthermore, the quality of evidence was examined utilizing the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methods.

Out of the 3,911 studies initially retrieved, only twenty-three fulfilled the criteria for inclusion in the systematic review. The majority of these studies demonstrated a notable impact on knee osteoarthritis. Among these, 21 studies that compared single OM treatment to conventional treatment were subjected to meta-analysis. The analysis of the effect size, measured as the standardized mean difference (SMD), indicated a "small effect" with 0.48 (Z = 2.98). Furthermore, a separate meta-analysis involving four studies assessing integrative therapy with conventional therapy revealed a "very large effect" with 1.52 (Z = 5.19).

Both OM and integrative therapies were favorable in reducing knee osteoarthritis pain. There was a limited number of RCTs exploring the efficiency of integrative therapy. This underscored the importance of conducting more RCTs in the future to further investigate the potential benefits of integrative approaches for knee osteoarthritis management.