Effects of therapeutic ultrasound in patients with knee osteoarthritis: A systematic review and meta-analysis
Yan Luo,
Masoud Rahmati,
Abdolreza Kazemi,
Wenbing Liu,
Seung Won Lee,
Razak M. Gyasi,
Guillermo F. López Sánchez,
Ai Koyanagi,
Lee Smith,
Dong Keon Yon
Affiliations
Yan Luo
Clinical Medicine Eight-Year Program, Xiangya Hospital, Central South University, Changsha, China
Masoud Rahmati
CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France; Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khoramabad, Iran; Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran; Corresponding author. CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France.
Abdolreza Kazemi
Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
Wenbing Liu
National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University, Wenzhou, 325027, China
Seung Won Lee
Department of Precision Medicine, Sungkyunkwan University College of Medicine, Suwon, Republic of Korea
Razak M. Gyasi
African Population and Health Research Center, Nairobi, Kenya; National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, New South Wales, Australia
Guillermo F. López Sánchez
Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
Ai Koyanagi
Research and Development Unit, Parc Sanitari Sant Joan de Déu, Dr. Antoni Pujadas, 42, Sant Boi de Llobregat, 08830, Barcelona, Spain
Lee Smith
Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
Dong Keon Yon
Center for Digital Health, Medical Science Research Institute, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea; Department of Pediatrics, Kyung Hee University College of Medicine, Seoul, Republic of Korea; Corresponding author. Department of Pediatrics, Kyung Hee University College of Medicine, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
Background: Therapeutic ultrasound (US) is a treatment for knee osteoarthritis (KOA), but its efficacy and safety are unclear. The objective of this study is to quantify the effect of US on pain relief and function recovery in KOA, and to analyze the US treatment duration and parameters on treatment outcome. Methods: We searched PubMed, MEDLINE, EMBASE, Google Scholar, Cochrane databases and ClinicalTrials.gov databases up to April 7, 2023. RCTs that compared the efficacy of therapeutic US with the control in KOA were included in the study, and the methodological quality of the trials was assessed using the Cochrane Risk of Bias tool. Results: Twenty-one RCTs (1315 patients) were included. US had a positive effect on visual analog scale (VAS) (SMD = −0.64, 95 % CI [-0.88, −0.40], I2 = 71 %) and Western Ontario and McMaster Universities (WOMAC) total scale (SMD = −0.45, 95 % CI [-0.69, −0.20]; I2 = 67 %). Pulsed US with an intensity ≤2.5 W/cm2 reduced visual analog scale (VAS), and differed in sessions (24 sessions (SMD = −0.80, 95 % CI [-1.07, −0.53], I2 = 0 %) vs 10 sessions (SMD = −0.71, 95 % CI [-1.09, −0.33], I2 = 68 %)). For pulsed US, a duration of treatment of 4–8 weeks (SMD = −0.69, 95 % CI [-1.13, −0.25], I2 = 73 %) appeared to be superior to ≤4 weeks (SMD = −0.77, 95 % CI [-1.04, −0.49], I2 = 0 %) for reducing visual analog scale (VAS). No US treatment-related adverse events were reported. Conclusion: Therapeutic US may be a safe and effective treatment for patients with KOA. The mode, intensity, frequency, and duration of US may affect the effectiveness of pain relief. Pulsed US with an intensity ≤2.5 W/cm2, 24 sessions, and a treatment duration of ≤4 weeks appears to have better pain relief.
