OBJECTIVE: To systemically review the effects of low-intensity pulsed ultrasound (LIPUS) on pain relief and functional recovery in patients with knee osteoarthritis (KOA). DATA SOURCES: PubMed, Web of Science, Cochrane Library, Physiotherapy Evidence Database (PEDro), and China National Knowledge Infrastructure (CNKI) were used from inception to 18 March 2022. REVIEW METHODS: Meta-analysis was performed to evaluate pain and function recovery between control and LIPUS groups. Standardized mean difference (SMD) or mean difference (MD) and 95% confidence interval (CI) were calculated, and data were combined using the fixed or random-effect model. RESULTS: Thirteen studies involving 807 patients with KOA were included. Patients' outcomes treated by LIPUS were improved significantly, including Visual analog scale (VAS) score (MD -0.95, 95% CI -1.43 to -0.48, p < 0.001), Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) score (MD -4.35, 95% CI -8.30 to -0.40, p = 0.0309), Lysholm score (SMD 1.59, 95% CI 1.29 to 1.90, p < 0.001), Lequesne index (MD -1.33, 95% CI -1.69 to -0.96, p < 0.001), Range of motion (ROM) (MD 2.43, 95% CI 0.39 to 4.46, p = 0.0197) and 50 meter walking time (SMD 1.48, 95% CI 0.46 to 2.49, p = 0.0044). Subgroup analyses showed monotherapy of LIPUS produced a better effect on reducing VAS score (p = 0.0213), and the shorter therapeutic period (<= 4 weeks) produced a more significant effect on raising the WOMAC score (p = 0.0083). CONCLUSION: LIPUS was beneficial for pain relief and functional knee recovery and maybe as an alternative therapy in KOA rehabilitation.

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