A Cochrane review [Abstract] 1 included 5 small studies with a total of 341 subjects with knee osteoarthritis (OA). No trial included patients with hip OA. Two evaluated pulsed ultrasound, two continuous and one evaluated both pulsed and continuous ultrasound as the active treatment. For pain, there was an effect in favour of ultrasound therapy, which corresponded to a difference in pain scores between ultrasound and control of -1.2 cm on a 10-cm VAS (95% CI -1.9 to -0.6 cm). For function, there was a trend in favour of ultrasound, which corresponded to a difference in function scores of -1.3 units on a standardised WOMAC disability scale ranging from 0 to 10 (95% CI -3.0 to 0.3). A high degree of heterogeneity among the trials was revealed for function (88%). Safety was evaluated in two trials (n=136); no adverse event, serious adverse event or withdrawals due to adverse events occurred in either trial.
Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment, lack of blinding, and inadequate intention-to-treat adherence) and by imprecise results (limited study size for each comparison).
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