Article

OBJECTIVE: To determine the feasibility of conducting a randomized controlled
trial assessing the effect of low-intensity pulsed ultrasound (US) therapy on
cartilage repair in patients with mild to moderate knee osteoarthritis (OA).
DESIGN: Pilot, double-blinded, randomized placebo-controlled trial with 2-months
follow-up. SETTING: Rehabilitation research facility. PARTICIPANTS: Adults (N=27;
>/=45y) with grades 1 or 2 of medial joint space narrowing (Osteoarthritis
Research Society International atlas) due to knee OA were randomly allocated to
receive active (n=14) or sham (n=13) US therapy. Four participants withdrew for
personal reasons. INTERVENTIONS: Twenty-four sessions of active (20% duty cycle,
1MHz, average temporal intensity: 0.2W/cm(2), therapeutic dose: 112.5J/cm(2)) or
sham (no sound-head crystal) US therapy. MAIN OUTCOME MEASURES: Success of
recruitment and adherence rates were established by a priori criteria. Effect on
cartilage repair was assessed by measuring cartilage volume and thickness and
scoring cartilage injury, subchondral cyst formation, and bone marrow lesions on
magnetic resonance images. RESULTS: Patient recruitment and adherence rates were
successful. No significant age-adjusted differences were seen between groups in
the cartilage repair outcomes. Age-adjusted analyses, including only subjects who
attended 20 sessions or more, showed an increase in medial tibia cartilage
thickness in the active US therapy group (90mum; 95% confidence interval, 1-200;
P=.05). CONCLUSIONS: Conducting a randomized controlled trial to assess the
effects of US therapy on the cartilage repair in people with mild to moderate
knee OA is feasible. However, further pilot studies are needed to determine the
optimal US dose and application parameters before designing a full trial.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS