Efficacy of a Deep Thermal Therapy System for Osteoarthritis of the Knee.

BACKGROUND: This study sought to assess the efficacy of a deep-tissue thermal therapy system with a resonant cavity applicator (DTT-RCA), which safely heats deep joint tissue for treating osteoarthritis (OA) of the knee. METHODS: Two groups of participants were recruited. The DTT-RCA group comprised 20 knees. Kellgren-Lawrence (K-L) grade was I and II in 8 knees (DTT-RCA I/II group) [mean age 73.3 years (standard deviation 11.4) ], III and VI in 12 knees (DTT-RCA III/IV group) [75.4 (8.6) years]. The control group comprised 13 knees [68.2 (10.8) years]. K-L grade was I in 7 knees and II in 6 knees. This group received exercise therapy. The DTT-RCA I/II group and the control group were imaged by MRI T2 mapping at baseline and 6 months to determine the area of cartilage degeneration. RESULTS: Visual Analogue Scale improved only in the DTT-RCA I/II post-intervention (p < 0.01). Japanese Orthopedic Association knee rating scores (DTT-RCA I/II: p < 0.01, control group: p < 0.01), the Japanese Knee Osteoarthritis Measure (DTT-RCA I/II: p < 0.05, control: p < 0.01), and the Knee injury and Osteoarthritis Outcome Score (DTT-RCA I/II: p < 0.01, DTT-RCA III/IV: p < 0.05, control: p < 0.01) post-intervention. The magnitude of change did not differ significantly between the three groups. The area of cartilage degeneration did not change significantly post-intervention in the DTT-RCA I/II group, not even relative to the control group. CONCLUSIONS: This was the first study to test a DTT-RCA system in patients with knee OA. The system reduced the clinical symptoms of knee OA and could potentially be effective for conservative therapy.

Deep heat therapy system with resonant cavity applicator for articular cartilage in knee osteoarthritis.

[Purpose] Heat can prevent cartilage degeneration when applied to articular cartilage, but the size of the human knee joint makes it difficult to target cartilage during heat treatment. In this study, we aimed to establish a heat therapy method capable of safely applying heat to deep intra-articular tissues utilizing a resonant cavity applicator and to confirm the extent of cartilage heating in the human knee when using this system. [Participants and Methods] Heating experiments were carried out on the knees of healthy three volunteers using a resonant cavity applicator and a microwave diathermy system. After heat application, temperature distributions inside the knee were measured noninvasively using our measurement method based on ultrasound imaging techniques. [Results] We observed an increase in the temperature around the cartilage tissue in the knees of the volunteers using an ultrasonic thermometer; there was no increase in temperature in the overlying layers. During heating with up to 20 W of power, none of the volunteers experienced adverse reactions. [Conclusion] This study indicates the potential safety and effectiveness of the resonant cavity heat therapy system for knee osteoarthritis in a clinical setting.

Validation of Noninvasive Ultrasound Temperature Measurement System Through Experiments Using Resonant Cavity Applicator.

We developed a resonant cavity applicator for noninvasive deep hyperthermia treatment of osteoarthritis. In previous studies, we confirmed its viability by heating agar phantoms and conducting computer simulations. To evaluate the heating performance of this system on human subjects, it is necessary to develop a new noninvasive temperature measurement system. In this study, we developed a new temperature measurement system utilizing ultrasound imaging techniques. After heating an agar phantom with our resonant cavity applicator, temperature measurements from both our custom-made noninvasive ultrasonic thermometer and an optical fiber thermometer were collected and compared. Both temperature distributions showed a reliable trend, with heat energy concentrated at the center of the agar phantom. Average error rates were less than 13% for temperatures. The results of this study describe the viability of the temperature measurement system and the resonant cavity applicator for clinical applications.