Short term efficacy of ibuprofen phonophoresis versus continuous ultrasound therapy in knee osteoarthritis.

Abstract

To compare the effectiveness of ibuprofen phonophoresis (PH) with conventional ultrasound (US) therapy in knee osteoarthritis. Sixty patients with a mean age of 59.8 +/- 9.0 years were randomly assigned to PH or US groups. Continuous ultrasonic waves of 1 MHz frequency and 1 watt/cm2 power were applied for 5 minutes to the target knee joint. Acoustic gel without any active pharmacological agent was applied in the US group, whereas cream containing 5% ibuprofen was applied in the PH group for a total treatment period of 10 sessions. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, pain on passive and active motion, 20 metres walking time, knee range of motion (ROM), and global assessments of disease activity and treatment efficacy by the investigator and by the patients were evaluated before and after therapy. Primary outcome measure of the study was 30% improvement in total WOMAC scores at the end of the study with respective scores at baseline. At the end of two weeks, 30% improvement in total WOMAC score was observed in 12 (40%) and 14 (46.6%) of patients in the PH and US groups respectively, indicating no significant difference in improvement rates. Pain scores, knee ROM degrees, 20 metres walking time measurements and all global assessment scores also improved significantly in both groups, yet these variables showed no significant differences between the two groups. When treatment efficacy was assessed as satisfaction rates, investigator satisfaction rates were 96.7% and 90%, while patient satisfaction rates were 93.3% and 83.3% in the PH and US groups respectively, suggesting similar satisfaction rates for both treatment methods. Both therapeutic modalities were found to be effective and generally well tolerated after 10 therapy sessions. Ibuprofen PH was not superior to conventional ultrasound in patients with knee osteoarthritis.