Effects of high voltage pulsed current (HVPC) on pain, inflammation, and mobility in patients with anterior knee pain: A randomized clinical trial

Anterior knee pain is a prevalent musculoskeletal condition that limits function and quality of life. High-voltage pulsed current (HVPC) has been proposed as an adjunct therapy for reducing pain and effusion and improving mobility; however, its clinical effectiveness remains unclear. This randomized clinical trial investigated the impact of HVPC on pain, knee effusion, and range of motion in patients with anterior knee pain. Ninety-six individuals were screened, and 86 were randomized to receive either HVPC plus a routine physiotherapy program (including infrared radiation, transcutaneous electrical nerve stimulation (TENS), and strengthening exercises; n = 43) or routine physiotherapy alone (n = 43). After attrition, 75 participants completed the study. Pain intensity was measured using a visual analogue scale (VAS). Knee effusion was assessed by measuring the circumference with a tape at the infra-, mid-, and supra-patellar levels. Range of motion was evaluated using goniometry. Assessments were conducted at baseline, after five treatment sessions, after ten sessions, and at one-month follow-up. Both groups demonstrated significant improvements over time in pain, effusion, and range of motion (all p<0.001). However, mixed two-factor analysis of variance revealed no significant group × time interaction for any outcome (pain p=0.61; infra-patellar effusion p=0.37; mid-patellar effusion p=0.50; supra-patellar effusion p=0.38; flexion p=0.09; extension p=0.08). These findings suggest that adding HVPC to routine physiotherapy does not provide additional clinical benefit. Routine physiotherapy, including TENS and exercise, remains an effective treatment option for managing anterior knee pain.