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bibliography * The PainScience Bibliography contains plain language summaries of thousands of scientific papers and others sources, like a specialized blog. This page is about a single scientific paper in the bibliography, Brinkhaus 2006.

Study shows Traumeel reduces knee swelling 0.7%

updated
Brinkhaus B, Wilkens JM, Lüdtke R, Hunger J, Witt CM, Willich SN. Homeopathic arnica therapy in patients receiving knee surgery: results of three randomised double-blind trials. Complement Ther Med. 2006 Dec;14(4):237–46. PubMed #17105693.
Tags: homeopathy, knee, surgery, medications, controversy, debunkery, leg, limbs, pain problems, treatment, self-treatment

PainSci summary of Brinkhaus 2006?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided at the bottom of the page, as often as possible. ★☆☆☆☆?1-star ratings are for negative examples, fatally flawed papers, junk science, suspected fraud. Ratings are a highly subjective opinion, and subject to revision at any time. If you think this paper has been incorrectly rated, please let me know.

This study compared a homeopathic preparation of arnica (Traumeel) to a placebo in patients who’d had knee surgery. Changes in swelling were determined by measuring knee circumference. Patients receiving the homeopathic arnica had 0.7% less swelling — a statistically meaningless figure. No one can detect a 0.7% reduction in swelling!

However, the authors — presumably pro-homeopathy, publishing in a homeopathy-friendly journal — somehow squeezed a positive conclusion out of these results by reporting only on the best-performing sub-group of 57 patients, who had 1.8% less swelling — statistically significant but still very small and from a small group. They also called the 0.25% change in the largest group of 227 a “positive trend,” which is extremely misleading. Statistically insignificant results aren’t a trend. An honest conclusion to this study would read, “Homeopathic arnica had no statistically significant effect on post-surgical knee swelling.”

Simple averaging of the results from all three groups results in the completely underwhelming 0.7% figure. Since all three groups were so similar, there’s no important reason to consider them separately.

~ Paul Ingraham

original abstractAbstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.

OBJECTIVES: We investigated the effectiveness of homeopathic Arnica montana on postoperative swelling and pain after arthroscopy (ART), artificial knee joint implantation (AKJ), and cruciate ligament reconstruction (CLR).

DESIGN: Three randomised, placebo-controlled, double-blind, sequential clinical trials.

SETTING: Single primary care unit specialised in arthroscopic knee surgery.

PARTICIPANTS: Patients suffering from a knee disease that necessitated arthroscopic surgery.

INTERVENTIONS: Prior to surgery, patients were given 1 x 5 globules of the homeopathic dilution 30x (a homeopathic dilution of 1:10(30)) of arnica or placebo. Following surgery, 3 x 5 globules were administered daily.

PRIMARY OUTCOME MEASURES: The primary outcome parameter was difference in knee circumference, defined as the ratio of circumference on day 1 (ART) or day 2 (CLR and AKJ) after surgery to baseline circumference.

RESULTS: A total of 227 patients were enrolled in the ART (33% female, mean age 43.2 years;), 35 in the AKJ (71% female, 67.0 years), and 57 in the CLR trial (26% female; 33.4 years). The percentage of change in knee circumference was similar between the treatment groups for ART (group difference Delta=-0.25%, 95% CI: -0.85 to 0.41, p=0.204) and AKJ (Delta=-1.68%, -4.24 to 0.77, p=0.184) and showed homeopathic arnica to have a beneficial effect compared to placebo in CLR (Delta=-1.80%, -3.30 to -0.30, p=0.019).

CONCLUSIONS: In all three trials, patients receiving homeopathic arnica showed a trend towards less postoperative swelling compared to patients receiving placebo. However, a significant difference in favour of homeopathic arnica was only found in the CLR trial.

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