Evaluation of the efficacy of catgut implantation at acupoint in the treatment of musculoskeletal pain: a protocol for systematic review and meta-analysis based on randomized controlled clinical trials.

Background and objectives: Musculoskeletal pain is one of the most common conditions in the general population, causing a variety of adverse effects. In addition to pharmacological treatments, the use of acupuncture has increased in recent decades and has shown satisfactory effects. However, the effect of catgut implantation at acupoint (CIA), a specific form of acupuncture, on the treatment of musculoskeletal pain has remained uncertain. Therefore, the aim of this study is to access whether CIA is effective and safe compared with other treatments for musculoskeletal pain.

Methods: Nine electronic databases, including six English databases (e.g. Medline and Embase) and three Chinese databases (e.g. CNKI and Wanfang database) will be searched from the inception to 1 May 2024. Only randomized controlled trials evaluating the effect of CIA for musculoskeletal pain in adults will be included. Two reviewers will independently perform the literature screening, data extraction and quality assessment. Primary outcome is pain symptoms assessed by any pain scale (e.g. visual analogue scale). Pooled results will be calculated using a fixed-effects model if heterogeneity is not significant (I²  < 50%), otherwise, a random-effects model will be used. Several subgroup analyses and sensitivity analyses will be performed. All statistical analyses will be conducted using STATA 18.0.

Results: A synthesis of the current evidence on the effect of CIA on the treatment of musculoskeletal pain will be published in a peer-reviewed journal.

Conclusions: This study will provide high quality evidence of the effect of CIA on the treatment of musculoskeletal pain.