A Meta‐Analysis of Analgesic Effect of Ultrasound Therapy for Patients With Knee Osteoarthritis

Abstract

To compare the efficacy of therapeutic ultrasound in pain relief and functional recovery in knee osteoarthritis. A comprehensive search of five databases including EMBASE, PubMed, CBM, the Cochrane Library, and Google scholar was conducted to identify relevant studies published between January 1, 2005 and December 31, 2020. Eligible randomized trials were screened for inclusion in this study. Data about the mean change of visual analogue scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and range of motion (ROM) were collected. Fourteen randomized trials covering 1080 patients with treatment durations of 2 to 24 weeks were included. Both pulsed (SMD [CI] = 1.11 [0.86, 1.36], P for heterogeneity < .00001, I2 = 18%) and continuous ultrasound (SMD [CI] = 1.18 [0.78, 1.57], P for heterogeneity < .00001, I2 = 72%) therapy had obvious pain relief effects, and high‐intensity (>1.5 W/cm2) ultrasound seemed more effective (SMD [CI] = 1.34 [0.94, 1.73], P for heterogeneity < .00001, I2 = 35%). In addition, therapeutic ultrasound was also effective in increasing joint function by WOMAC (SMD [CI] = 8.18 [5.88, 10.48], P for heterogeneity < .00001, I2 = 59%). There was a certain degree of heterogeneity due to the differences between the subjects in the study and the ultrasound parameter settings. Our analysis confirmed that both pulsed and continuous ultrasound are effective and safe for pain relief and functional recovery of knee osteoarthritis, especially in high intensity (> 1.5 W/cm2). However, more high‐quality randomized controlled trials will be necessary.

Effects of therapeutic ultrasound in patients with knee osteoarthritis: A systematic review and meta-analysis

“…A subgroup analysis of 2 different US models performed by Liu 2022 [ 18 ] showed that both pulsed and continuous therapeutic US were effective in relieving pain. In addition, a direct comparison between pulsed US and continuous US was also performed, showing no significant difference between the two modalities.…”

“…A review of the evidence found that the analgesic and functional effects of US on KOA are inconclusive [ 13 ]. Previous systematic reviews on the effectiveness of US in the treatment of KOA are outdated [ [14] , [15] , [16] , [17] , [18] , [19] , [20] ], and even the latest meta-analysis [ 18 ] published in 2022, only included trials up to December 2020, and the quality of the included trials was poor. Some systematic reviews and meta-analyses only studied the efficacy analysis of low-intensity US therapy or pulsed US for KOA and did not include other types of US [ [21] , [22] , [23] ], some only compare therapeutic US with sham US (or no intervention) without considering concurrent treatment [ 17 , 19 ].…”

Osteogenic effect of low-intensity pulsed ultrasound on peri-implant bone: A systematic review and meta-analysis

“…Low-intensity pulsed ultrasound (LIPUS) is a noninvasive therapeutic approach that has been used for several years as a supplement for bone healing. Usually, LIPUS treatment for bone repair is applied once daily by using a transducer placed on the surface of the skin over the fracture site [3]. The tissue repair effect of LIPUS is primarily attributed to its mechanical and thermal properties.…”

“…The tissue repair effect of LIPUS is primarily attributed to its mechanical and thermal properties. The main therapeutic effect of LIPUS results from its mechanical effects [3]. The propagation of LIPUS through the medium causes the movement of substances, which produces a massage effect on cells in the medium [3].…”

Standardized Mean Difference Versus Weighted Mean Difference for Summarizing the Effect of Ultrasound Therapy for Patients With Osteoarthritis

“…In the commented article, 1 we identified the standardized mean difference (SMD) had been used to quantify the outcome. The SMD is derived from the between-group difference in means divided by the pooled standard deviation.…”