Tramadol Iontophoresis Added to Treatment of Knee Osteoarthritis

Abstract

Objective: The objective of the present study was to investigate whether tramadol iontophoresis added to therapy is superior to the therapy methods alone (transcutaneous electrical nerve stimulation (TENS), hot pack, ultrasound, and exercise therapy) in patients with knee OA. Materials and Methods: A total of 72 patients who admitted to the outpatient clinic of Physical Medicine and Rehabilitation were included in this study. The diagnosis was based on the American College of Rheumatology (ACR) criteria for knee OA. The patients were randomly separated into two groups. Group 1 received physical therapy and Group 2 received tramadol iontophoresis in addition to the therapy for a period of two weeks. Patients were evaluated according to pain and functional capacity assessed using visual analogue scale (VAS) and Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) before therapy and following the 10th session, and at 1 and 3 months. Results: The mean age and duration of the knee pain were 58.53±8.38, 5.00±2.66 years in the control group and 58.15±7.70, 4.71±2.70 years in the tramadol iontophoresis group. There were no significant differences between groups in the mean age and duration of the knee pain, body mass index (BMI), VAS and WOMAC scores before therapy. Following the 10th session, and after 1 and 3 months, VAS and WOMAC scores were significantly decreased in both groups when compared with the baseline values (p<0.001). VAS scores were significantly lower in the tramadol iontophoresis group compared to controls following the 10th session (p<0.001). However, no significant difference was found between WOMAC scores of the tramadol iontophoresis and control groups (p>0.05). Conclusion:We conclude that tramadol iontophoresis added to physical therapy may be useful for relieving pain of knee OA during the treatment period. (Turk J Rheumatol 2010; 25: 174-8

Evaluation of the Effectiveness of Iontophoresis with Perskindol Gel in Patients with Osteoarthritis of the Knee Joints

“…The literature quotes studies on the use of iontophoresis with NSAIDs and steroid drugs in the treatment of patients with OA [ 8 , 9 , 10 , 11 , 12 , 13 , 42 ]. A previous study focused on the determination of the current polarization suitable for the introduction of ketoprofen into the rat knee joint [ 47 ].…”

“…The therapeutic approach should be individually tailored to the needs and physical condition of the patient, and aimed at improving the quality of life and postponing or, if possible, avoiding surgery [ 7 , 8 ]. Physical procedures with the use of direct current, such as galvanic treatment and iontophoresis, are widely used in the treatment of OA [ 8 , 9 , 10 , 11 , 12 ].…”

“…Each patient was interviewed and underwent a physical examination, taking into account the scales and questionnaires described below [ 10 , 12 , 42 , 43 , 44 , 45 , 46 ]:…”

Design of a Device for Treatment of Knee Osteoarthritis with TENS, EMS and Iontophoresis through an Android Application on a Smartphone

“…This helps reduce the amount of pain medication and the negative effects that are generated in some organs due to drug treatment. Iontophoresis induce the drug administration in the knee through a localized skin [11] avoiding side effects in other organs. The EMS current prevents decrease in muscle mass and decreased fragility of the joint [12,13,14].…”

Quality of Randomized, Controlled Trials Published in Our National Journals

“…[8][9][10][11][12][13][14][15][16][17][18][19] One of the major problems of the RCTs was the insufficient information regarding the method of randomization and allocation concealment. RCTs with an unclear generation of the allocation sequence, allocation concealment and double blinding frequently overestimate intervention efficacy.…”