Effect of Low-Intensity Pulsed Ultrasound on Quality of Life of Knee Osteoarthritis

Abstract Background Non-union occurs in approximately 5 to 10% of fracture patients, with certain bones at greater risk of failing to heal. Non-unions have a significant impact on socioeconomic costs and the patients short and long-term quality of life. Low intensity pulsed ultrasound (LIPUS) is a non-invasive therapy for non-union treatment that can improve the long-term outcome. The purpose of this study is to summarize the available literature assessing LIPUS potential to improve the union rate in instrumented, infected, and fragility non-unions. Methods A literature search was conducted in the MEDLINE, EMBASE, and CINAHL databases for all relevant literature on the healing rates of LIPUS utilized in instrumented, infected, and fragility non-unions. Study characteristics were summarized for each of the included studies. The percentage of healed patients (healing rate), for instrumented, infected, and fragility fracture non-union patients were pooled from each included study. Results The literature search identified a total of 326 articles, while searching reference lists and grey literature identified an additional 3 articles. There was a total of 29 articles included in this review, with 20 articles included within the quantitative synthesis of healing rates. The most common design of included studies was case series (17 articles), followed by case reports (9 articles). Studies were primarily retrospective (18 studies), with an additional 10 prospective studies. Non-union healing rates were 82% (95% CI: 76 to 87%) in instrumented, 82% (95% CI: 70 to 95%) in infected, and 91% (95% CI: 87 to 95%) in fragility fracture patients with non-unions. Conclusion This study has provided a thorough overview of the current literature on LIPUS treatment for instrumented, infected, and fragility fracture non-unions. The healing rates for non-unions in these subgroups were comparable to healing rates observed with LIPUS use in general non-union literature. LIPUS treatment should be considered as a conservative non-surgical treatment option to potentially reduce the socioeconomic impact and improve the quality of life of these unfortunate patients. Level of evidence 4 (systematic review of primarily case series data)

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How the Future of Sonography May Change the Outlook for Patients With Osteosarcoma

Journal of Diagnostic Medical Sonography ◽

10.1177/8756479318769237 ◽

2018 ◽

Vol 34 (5) ◽

pp. 368-373

Author(s):

Stacey Hoya ◽

Linda Wogeman ◽

Sara Allstadt ◽

Glen King

Keyword(s):

Quality Of Life ◽

Focused Ultrasound ◽

Treatment Plan ◽

Treatment Options ◽

Therapeutic Ultrasound ◽

Bone Lesions ◽

Pulsed Ultrasound ◽

Low Intensity Pulsed Ultrasound ◽

Ultrasound Applications

Sonography currently provides a variety of tools to support the diagnosis and treatment of osteosarcoma and, with the development of therapeutic ultrasound practices, could play an increasingly important role in the treatment of future patients with osteosarcoma. Currently, computed tomography, magnetic resonance imaging, and radiography are the preferred imaging modalities for bone lesions; treatment options for osteosarcoma primarily include highly toxic chemotherapies and surgeries that often result in limb loss. Unfortunately, osteosarcoma is rarely eliminated, and despite this, patients lose their lives after having a significant reduction in quality of life. Evolving therapies such as high-frequency focused ultrasound, ultrasound-enhanced delivery of photodynamic therapy, and low-intensity pulsed ultrasound may offer these patients an improved quality of life while also increasing efficacy of treatment. This canine case study illustrates the various ways in which sonography might contribute to the treatment plan for patients with osteosarcoma. It may provide a comparable model for the reimagining of treatment for future patients with osteosarcoma using a suite of therapeutic ultrasound applications.

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Efficacy of focused low-intensity pulsed ultrasound therapy for the management of knee osteoarthritis: a randomized, double blind, placebo-controlled trial

Scientific Reports ◽

10.1038/srep35453 ◽

2016 ◽

Vol 6 (1) ◽

Cited By ~ 24

Author(s):

Lang Jia ◽

Yan Wang ◽

Jinyun Chen ◽

Wenzhi Chen

Keyword(s):

Knee Osteoarthritis ◽

Controlled Trial ◽

Ultrasound Therapy ◽

Pulsed Ultrasound ◽

Double Blind ◽

Double Blind Placebo ◽

Low Intensity Pulsed Ultrasound ◽

Low Intensity

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Effect of Low-Intensity Pulsed Ultrasound on the Cartilage Repair in People With Mild to Moderate Knee Osteoarthritis: A Double-Blinded, Randomized, Placebo-Controlled Pilot Study

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2011.07.196 ◽

2012 ◽

Vol 93 (1) ◽

pp. 35-42 ◽

Cited By ~ 42

Author(s):

Adalberto Loyola-Sánchez ◽

Julie Richardson ◽

Karen A. Beattie ◽

Carmen Otero-Fuentes ◽

Jonathan D. Adachi ◽

...

Keyword(s):

Pilot Study ◽

Knee Osteoarthritis ◽

Cartilage Repair ◽

Pulsed Ultrasound ◽

Low Intensity Pulsed Ultrasound ◽

Low Intensity ◽

Double Blinded

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Effect of Low-Intensity Pulsed Ultrasound on Extracellular Matrix and MAPKs Signaling Pathways in Early and Medium Term of Rabbit Knee Osteoarthritis Model

Advanced Science Letters ◽

10.1166/asl.2012.3293 ◽

2012 ◽

Vol 16 (1) ◽

pp. 193-198

Author(s):

Mingxia Gao ◽

Kai Cheng ◽

Qiang Lin ◽

Daxin Wang ◽

Junlong Yu ◽

...

Keyword(s):

Extracellular Matrix ◽

Knee Osteoarthritis ◽

Signaling Pathways ◽

Pulsed Ultrasound ◽

Medium Term ◽

Rabbit Knee ◽

Low Intensity Pulsed Ultrasound ◽

Low Intensity

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Effects of low intensity pulsed ultrasound to reduce the effusion volumes and pain with knee osteoarthritis: a randomized controlled trial

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20185145 ◽

2018 ◽

Vol 5 (1) ◽

pp. 77

Author(s):

P. Shanmuga Raju ◽

Chokkarapu Ramu ◽

N. S. Harshavardhan ◽

K. Rajender ◽

G. Sachin

Keyword(s):

Randomized Controlled Trial ◽

Knee Osteoarthritis ◽

Controlled Trial ◽

Control Group ◽

Ultrasound Therapy ◽

Pulsed Ultrasound ◽

Low Intensity Pulsed Ultrasound ◽

Low Intensity ◽

Randomized Controlled ◽

And Control

Background: The study aim was to determine the effect of low intensity pulsed ultrasound therapy to reduce the effusion volumes and pain in patients with Knee OA.Methods: This study design was randomized controlled trial. Total 50 patients diagnosed with Knee osteoarthritis were randomly assigned to two groups. Group I was using treatment of low intensity pulsed ultrasound therapy and group II was administered TENS with home exercise respectively. Treatments were 6 days per week and duration of 2 week. The amount of effusion volume will be measured via ultrasonograpy in knee.Results: The maximum number of cases are lying in age group >60 years which is 28% and 40% in cases and control group respectively and age distribution in both the group is statistically not significant. The mean age of patients in cases and control group is 57.08±7.40 years and 58.04±9.93 years respectively.Conclusions: Low intensity pulsed ultrasound therapy significantly reduced the effusion volumes and pain in patients with knee osteoarthritis.

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Efficacy and Safety of a Stimulator Using Low-Intensity Pulsed Ultrasound Combined with Transcutaneous Electrical Nerve Stimulation in Patients with Painful Knee Osteoarthritis

Pain Research and Management ◽

10.1155/2019/7964897 ◽

2019 ◽

Vol 2019 ◽

pp. 1-10 ◽

Cited By ~ 1

Author(s):

Eu-Deum Kim ◽

Yu Hui Won ◽

Sung-Hee Park ◽

Jeon-Hwan Seo ◽

Da-Sol Kim ◽

...

Keyword(s):

Knee Osteoarthritis ◽

Transcutaneous Electrical Nerve Stimulation ◽

Cartilage Regeneration ◽

Efficacy And Safety ◽

Pulsed Ultrasound ◽

Electrical Nerve Stimulation ◽

Low Intensity Pulsed Ultrasound ◽

Low Intensity ◽

Posttreatment Period ◽

Painful Knee

Objective. Studies regarding the combination of ultrasound and transcutaneous electrical nerve stimulation (TENS) are rarely reported. In this study, we aimed to elucidate the efficacy and safety of a stimulator using low-intensity pulsed ultrasound (LIPUS) combined with TENS in patients with painful knee osteoarthritis (OA). We evaluated the effectiveness of this therapy against pain, physical function, and cartilage regeneration. Moreover, we aim to prove the superiority of the effects of LIPUS combined with TENS therapy compared with only TENS therapy.Methods. Of the 40 included patients, aged 45–85 years with painful knee OA, 20 patients received only TENS therapy and 20 patients received LIPUS combined with TENS therapy for 8 weeks (a total of more than 80 treatment sessions). We evaluated visual analogue scale (VAS), Western Ontario and McMaster Universities (WOMAC) osteoarthritis index, MOS 36-Item Short-Form Health Survey (SF-36), and femoral articular cartilage (FAC) thickness. The evaluation was performed at three visits: visit 1 (V1, pretreatment, within 28 days after screening), visit 2 (V2, posttreatment period 1, ±3 days after treatment), and visit 3 (V3, posttreatment period 2, 21 ± 3 days after treatment).Results. We expected that LIPUS combined with TENS therapy would be superior to only TENS therapy. However, there was no significant difference between the two therapies. In the within-group comparison, both treatments (only TENS therapy and LIPUS with TENS therapy) demonstrated statistical differences from baseline values for pain and physical function outcomes. FAC thickness showed no significant differences after treatment in both groups.Conclusion. The effects of a stimulator using LIPUS with TENS on pain relief and functional improvement were not superior to the only TENS therapy. Cartilage regeneration, which was expected as an additional benefit of LIPUS, was also not significantly evident. Therefore, further investigation is warranted to determine whether the combination therapy is beneficial. This trial is registered withKCT0003883.

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