Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2021; 88(2):117-123 | DOI: 10.55095/achot2021/020

Comparison of the Efficacy of Different Concentrations of Diclofenac Sodium Phonophoresis (1.16% vs 2.32%) in Patients with Knee Osteoarthritis: a Randomized Double-Blind Controlled TrialOriginal papers

S. TOLU^1,*, M. M. KÖSE², M. C. KORKMAZ³, A. ÜŞEN¹, A. REZVANݹ

¹ Istanbul Medipol University Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey

² Karaman Medical Center, Department of Physical Medicine and Rehabilitation, Karaman, Turkey

³ Başakşehir Cam and Sakura State Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey

PURPOSE OF THE STUDY:
The objective of the present study is to compare the efficacy of two different concentrations of diclofenac sodium phonophoresis (DSPH) (1.16% vs 2.32%) in patients with knee osteoarthritis (OA).

MATERIAL AND METHODS:
A randomized, double-blind, controlled design was applied. Ninety patients (mean age± SD, 59.98 ± 8.89 years) who had Kellgren-Lawrence (K-L) grades II to III knee OA were randomly allocated into three groups; 1.16% DSPH, 2.32% DSPH, TUS (30 in each group). Each patient was treated five sessions per week for two weeks. A 100-mm visual analogue scale (VAS) for usual pain and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were evaluated before and after treatment in all groups.

RESULTS:
The VAS pain and WOMAC scores were significantly improved after treatment in all groups (p < 0.05). The 2.32% DSPH showed more significant effects than the 1.16% DSPH, both in improving WOMAC-pain and physical function scores (p = 0.020, p = 0.008) and reducing the VAS pain measure, although it did not reach the level of significance (p = 0.077). The 2.32% DSPH was superior to the TUS, both in reducing the VAS pain measure (p < 0.001) and in improving WOMAC-pain, stiffness, physical function and total scores (p = 0.022, p = 0.016, p < 0.001, p < 0.001 respectively). 1.16% DSPH significantly reduced stiffness and physical function scores compared with TUS (p = 0.042, p = 0.047).

CONCLUSIONS:
DSPH and TUS are effective treatments for knee OA. Our results indicated that 2.32% DSPH produces additional benefits to functional improvement and pain reduction compared with 1.16% DSPH in K-L grades II to III knee OA.

Keywords: diclofenac sodium, knee osteoarthritis, phonophoresis, therapeutic ultrasound, topical formulation

Published: April 15, 2021  Show citation