Effect of Different Intensity Ultrasound on Femoral Cartilage Thickness and Symptomatic Relief in Knee Osteoartritis: A Randomized, Controlled Double-Blind Study

ABS TRACT Objective: Therapeutic ultrasound is a noninvasive and easily applicable treatment method used for musculoskeletal pain.The aim of this randomized, double-blind, controlled study is to evaluate the effects of different ultrasound intensities on pain and function in patients with knee osteoarthritis.Material and Methods: This single-center, prospective, randomized, double-blind, controlled study included 90 patients diagnosed with knee osteoarthritis (Kellgren-Lawrence stage II-III) according to ACR criteria and experiencing moderate-to-severe knee pain.Patients were randomly assigned to three groups (n = 30) using a computer-generated random number table.All patients received a standard exercise program combined with hot pack, TENS, and continuous ultrasound therapy for 3 weeks (5 days per week, totaling 15 sessions).Pain (VAS), function (Western Ontario and McMaster Universities Arthritis Index (WOMAC), Lequesne index), and femoral cartilage thickness (ultrasonography) were measured by a blinded evaluator before treatment, at the end of treatment, and at 1 month.Ultrasound wave frequencies were set at 1 MHz, 1 W/cm for the first group; 1.5 W/cm for the second group; and 2 W/cm for the third group.Results: There were no demographic differences between the groups (p>0.05).In all groups, significant improvement was observed in VAS, WOMAC subscores, Lequesne index, and femoral cartilage thickness at both the end of treatment and 1 month after treatment compared to baseline (p<0.001).However, no statistically significant differences were found between the three groups in terms of clinical scores and cartilage thickness changes (p>0.05).Conclusion: Long-term low-intensity ultrasound significantly reduced pain and improved joint function in patients