OBJECTIVE: The present objective was to determine the efficacy of ultrasound applications in decreasing the pain and improving the function of people with osteo-arthritis of the knee. METHODS: Using Medline, Excerpta Medica and CINAHL databases for the period 1966 to 1999, as well as a manual search dating back to 1950, the five English language publications found detailing the controlled application of ultrasound for treating knee osteo-arthritis were critically examined with respect to experimental design and significance of results for the profession of physiotherapy. RESULTS: Clear evidence of the efficacy of ultrasound as a treatment for knee osteo-arthritis was found in only one of the studies appraised but this incorporated a poor study design, rendering its results questionable. The remaining studies which found either equitable outcomes between groups treated with ultrasound, or other modalities, or no benefit when compared to sham ultrasound, were similarly flawed. CONCLUSIONS: Further research studies, using sound methodologies, are needed to clarify whether ultrasound, an expensive and time-consuming treatment, has any unique disease modifying effects as indicated in basic science studies; and whether ultrasound is superior to the provision of personalised attention or less time-consuming therapies for treating knee joint disease at specific disease stages or for treating specific disease manifestations selectively.

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