Assesing the effects of pulsed ultrasound treatment on pain, functionality, synovial fluid and cartilage thickness, i̇n knee osteoarthritis, preliminary study results

OBJECTİVE: To evaluate the effect of pulsed ultrasound treatment on cartilage regeneration, inflammation and quality of life in patients with knee osteoarthritis. MATERIAL AND METHODS: The study is a randomised, controlled, double blind and parallel group study that included 61 patients (121 knees). The patients have knee ostearthritis according to American College of Rheumatology (ACR) diagnostic criteria and Kellgren-Lawrence grades were ≤3. The treatment group (n:31, 62 knees) received 10 minutes of pulsed (Ratio: 1:4) ultrasound treatment with 1MHz probe, an intensity of 1w/cm2 3 times a week during 8 weeks, a total of 24 sessions. The control group (n:30, 59 knees) received sham US treatment for the same time and frequency as treatment group. Both of the groups received home exercise program. Patients evaluated before and after treatment and at 3rd month with ultrasonographic measurements (Synovial fluid amount, femoral cartilage thickness) and quality of life tests (VAS, WOMAC, TUG(Timed up and go) test). RESULTS There was no difference between the two groups in terms of age, gender, symptom duration, body mass index, resting VAS, walking VAS, WOMAC total score, TUG test time, synovial fluid measurement. However, femoral cartilage thickness was significantly better in the control group before treatment. Both groups showed significant improvement in resting VAS, walking VAS, WOMAC total scores after treatment and at 3rd month, whereas only the treatment group showed a significant improvement in TUG test. When comparing groups in terms of changes, only walking VAS score improvement was signicantly more in favor of treatment group. There was no significant difference between groups in terms of synovial fluid and femoral cartilage thickness measurements after treatment and 3rd month. CONCLUSION Our study is unique because it is the first study that evaluates the effect of therapeutic ultrasound on synovial fluid and cartilage thickness with ultrasonography. According to this preliminary study data; therapeutic ultrasound treatment in addition to home exercise program has been shown to be effective only on pain caused by walking in the knee; but its effectiveness on functionality, synovial fluid and femoral cartilage thickness has not been demonstrated in the treatment of knee osteoarthritis.