OBJECTIVE: To explore the effects of therapeutic ultrasound with sham or no intervention on pain, physical function and safety outcomes in patients with knee osteoarthritis. DATA SOURCES: This systematic review was searched on CENTRAL, Embase, Medline, CINAHL, Physiotherapy Evidence Database, Open Gray on 4 September 2015. Trials included randomized controlled trials that compared therapeutic ultrasound with a sham or no intervention in patients with osteoarthritis of the knee. REVIEW METHODS: Eligible trials and extracted data were identified by two independent investigators. Standardized mean differences (SMDs) and 95% confidence interval (CI) were calculated for pain and physical function outcomes. Heterogeneity was assessed by the I2 test and inverse-variance random-effects analysis was applied to all trials. RESULTS: Ten randomized controlled trials (645 patients) met the inclusion criteria. Therapeutic ultrasound showed a positive effect on pain (SMD -0.93, 95% CI -1.22 to -0.64, p < 0.01, p for heterogeneity = 0.12, I2 = 42%). For physical function, therapeutic ultrasound was advantageous for reducing Western Ontario and McMaster Universities physical function score (SMD -0.37, 95% CI -0.73 to -0.01, p = 0.04, p for heterogeneity = 0.94, I2 = 0%). In terms of safety, no occurrence of adverse events caused by therapeutic ultrasound was reported in any trial. CONCLUSION: The authors suggested that therapeutic ultrasound is beneficial for reducing knee pain and improving physical functions in patients with knee osteoarthritis and could be a safe treatment.

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