The effect of additional therapeutic ultrasound in patients with primary hip osteoarthritis: a randomized placebo-controlled study

Abstract

To the best of our knowledge, there is no study in the English literature about the usefulness of ultrasound therapy in degenerative hip osteoarthritis. The aim of this study was to examine its short- and long-term efficacy in patients with primary hip osteoarthritis with regard to pain, functional status, and quality of life (QoL). Forty-five patients with primary hip osteoarthritis were enrolled into the study. Demographic and clinical characteristics including age, sex, duration of disease, and pain on activity and at rest using visual analogue scale (VAS) were recorded. Functional status was determined by a 15-m timed walking test and Western Ontario McMaster Osteoarthritis Questionnaire. QoL was determined by the Short Form-36 survey (SF-36). Each patient was randomly assigned to either group I (standard physical therapy including hot pack and exercise program), group II (sham ultrasound in addition to standard physical therapy), or group III (ultrasound and standard physical therapy). The main outcome measures of the treatment were pain intensity by VAS; functional status measurements that were evaluated at baseline, at the end of the therapies, and at the first and third month of follow-up; and QoL scores that were determined at baseline and at the end of the first and third months. Twelve male and 33 female patients (mean age, 65.3 ± 6.7 years; mean disease duration, 2.5 ± 1.7 years) were included in the study. There were no differences between the groups regarding demographic variables on entry to the study. There were 15 patients in each group. Pain and functional outcome measures were determined to have improved significantly in all of the groups at the end of the therapies, but these improvements continued at the end of the first and third months only in group III (p < 0.001) The physical subscores of SF-36 were improved at the end of the first month and were maintained at the end of the third month only in patients receiving additional ultrasound therapy (group III, p < 0.001), while mental subscores of SF-36 did not change significantly in any group. In conclusion, addition of therapeutic ultrasound to the traditional physical therapy showed a longitudinal positive effect on pain, functional status, and physical QoL in patients with hip osteoarthritis. The use of therapeutic ultrasound in the treatment of hip osteoarthritis should be encouraged, and it seems worthy to continue with large clinical trials on ultrasound in order to standardize the treatment modality in this patient group.

Efficacy of ultrasound in the treatment of osteoarthritis of the knee

“…Köybaşi et al . recommended using therapeutic ultrasound in the management of hip osteoarthritis, and believed that large clinical trials on ultrasound were necessary in order to standardize the treatment modality in this patient group 17 . Because the extent to which ultrasound produces pain relief and functional improvement in KOA patients is still uncertain, further study is needed 18 .…”

Efficacy of conservative treatment regimes for hip osteoarthritis - Evaluation of the therapeutic exercise regime "Hip School": A protocol for a randomised, controlled trial

“…Despite low quality of given evidence, therapeutic ultrasound may be beneficial for patients with osteoarthritis of the knee [ 48 ]. In subjects with hip OA, ultrasound in addition to standard physiotherapy has been shown to be superior in terms of a longitudinal positive effect on pain, functional status, and physical quality of life in comparison to a standard physiotherapy with and without sham ultrasound [ 49 ]. Safety of this intervention has yet not been disproved, and to date no serious adverse events have been reported [ 48 ].…”

Effect of low-intensity long-duration ultrasound on the symptomatic relief of knee osteoarthritis: a randomized, placebo-controlled double-blind study

“…These results are consistent with ultrasound literature for the symptomatic treatment of OA [ 14 ]. In a randomized, placebo-controlled study of daily ultrasound to treat hip osteoarthritis for 2 weeks, a significant 1.2-point difference on the visual analogy scale was found [ 15 ]. Another placebo-controlled study of ultrasound on knee osteoarthritis found similar results with a 2.8-point decrease in pain on the NRS after ten treatment sessions, and a significant 1.7-point difference in pain score between active and placebo ultrasound [ 16 ].…”