Effects of low-intensity pulsed ultrasound on knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials.
Haoqian Chen, Zheng Wang, Xinan Zhang and 1 others
PMID 35535403WHAT IT FOUND
Low-intensity pulsed ultrasound was linked to less pain and better knee function in osteoarthritis across 13 small trials, but in most of them it was added to exercise, drugs or TENS, so the ultrasound's own contribution is unclear.
Key findings
01Across 12 trials with 783 people, those who received low-intensity pulsed ultrasound reported significantly less knee pain than controls on a visual analog scale, but the trials disagreed strongly with each other.
02Pooled results also favoured ultrasound for physical function: WOMAC scores across 6 trials, Lysholm scores across 3 trials and Lequesne index scores across 5 trials all improved significantly.
03Only 3 of the 13 trials used ultrasound on its own; the other 10 added it to another treatment such as exercise, NSAIDs, TENS or self-directed therapy, so the contribution of the ultrasound alone cannot be separated.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only studies published in English or Chinese were considered, so trials in other languages were missed. Patients in the included trials had different severities of knee osteoarthritis, and the authors say this may have overestimated the effect of ultrasound on pain and function. The ultrasound devices and treatment protocols differed between trials, which the authors say contributed to the inconsistency in the results. Follow-up was short, ranging from 2 weeks to 1 year, so whether any benefit lasts is unknown. The review found no data on adverse effects of ultrasound in these patients. Only studies from countries and regions in Asia were included, so the results may not carry over to other populations. Most pooled outcomes showed substantial inconsistency between trials, and none of the subgroup analyses adequately explained it.
Declared interests
The authors declared no conflicts of interest. The work was funded by a research grant from the Department of Education of Liaoning Province, China (LJKZ1048). No ultrasound manufacturer or other commercial party is reported as involved in funding, design or writing.
The easy way to misread this
Do not read this as proof that ultrasound on its own treats knee osteoarthritis. Only three of the thirteen trials gave low-intensity pulsed ultrasound by itself; the other ten added it to exercise, NSAIDs, TENS or injections, so the improvement seen here may come from those treatments as much as from the ultrasound.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →