Trial reportJournal of orthopaedic surgery and research2025
Synergistic effects of low-intensity pulsed ultrasound and extracorporeal shock wave therapy in knee osteoarthritis: clinical outcomes and biochemical mechanisms.
Trial report in Journal of orthopaedic surgery and research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
1 citing paper in PubMed.
- Extracorporeal Shock Wave Therapy in Knee Osteoarthritis: A Mechanistic Narrative Review of Neurogenic Inflammation and the MMP/ADAMTS Axis.International journal of general medicine · 2026Review
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundKnee Osteoarthritis (KOA) is a degenerative joint condition that leads to pain and limited mobility. Non-invasive treatments like Low-Intensity Pulsed Ultrasound (LIPUS) and Extracorporeal Shockwave Therapy (ESWT) help manage symptoms and support recovery. While both methods are effective, no studies have directly compared ESWT alone to its combination with LIPUS (LESWT) for KOA. This study aims to assess their efficacy and provide evidence for treatment choices.
methodsThis randomized controlled trial (RCT) used computer-generated block randomization with allocation concealment via sequentially numbered opaque envelopes. Outcome assessors were blinded to treatment allocation; though complete patient blinding was not feasible due to the physical nature of the interventions (LESWT vs. ESWT). Radial extracorporeal shock wave therapy (R-ESWT) was administered using a radial applicator (MASTERPULS MP100 Ultra; Storz Medical, Switzerland) at 10 Hz and 3 bar with 2,000 impulses per session. LIPUS was applied at 1 MHz and 0.5 W/cm
resultsThe LESWT group showed a higher clinical effective rate (81.57%) compared to the R-ESWT group (64.82%, p < 0.01), with greater improvements in the Lysholm Knee Scoring Scale (LKSS), Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and range of motion (ROM) scores (p < 0.05). Levels of inflammatory markers (nitric oxide [NO], interleukin-1β [IL-1β], tumor necrosis factor-α [TNF-α], matrix metalloproteinase-3 [MMP-3]) declined, whereas superoxide dismutase [SOD] and transforming growth factor-β1 [TGF-β1] levels rose, with the LESWT group exhibiting more pronounced changes (p < 0.01). The occurrence of adverse events showed no significant difference between the groups (p > 0.05).
conclusionLESWT demonstrates significant efficacy in alleviating pain and reducing inflammatory markers in patients with KOA, making it a promising therapeutic option deserving of further clinical consideration.
trial registrationThe study protocol was registered on ClinicalTrials.gov registration with the register number CTR2457249805 (registration date: 2022/08/03).
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