title: Absorption of hydrocortisone acetate in human connective tissue using phonophoresis.
abstract: BACKGROUND
  Therapeutic ultrasound to drive medication (phonophoresis) has been a mainstay in physical therapy. The most common drug used in phonophoresis is hydrocortisone acetate (HA). A number of studies have been done examining phonophoresis in the delivery of HA through the skin to underlying tissues; however, a study has never been done examining the absorption of HA using phonophoresis on human connective tissue.
  
  
  OBJECTIVE
  Phonophoresis will facilitate the transmission of HA in human connective tissue.
  
  
  METHODS
  Randomized controlled study.
  
  
  METHODS
  Twenty-one patients undergoing anterior cruciate ligament reconstruction surgery were randomly assigned to either a sham or true phonophoresis treatment group. The latter group received 6 minutes of 10% HA ultrasound at a point consistent with the gastrocnemius slip of the semitendinosis tendon (treatment site). The sham group received 6 minutes of 10% HA ultrasound to the same area, but the ultrasound was not turned on. The slip and a sample of the distal attachment of the tendon (control) were removed. Samples were analyzed for HA levels.
  
  
  RESULTS
  Although the mean and median levels of HA found at the treatment site were greater than those of the control site (means, 34.1 vs 22.9 parts per billion; medians, 7 vs 0 parts per billion), the levels of HA found at the treatment site were not significantly greater than those at the control site (P = 0.15). There were no statistically significant differences between the true and sham phonophoresis groups in HA levels (P = 0.80) nor in age, sex, or skin thickness.
  
  
  CONCLUSIONS
  Phonophoresis does not appear to facilitate the absorption of HA in connective tissue when compared with simple absorption (sham).
  
  
  CONCLUSIONS
  Phonophoresis does not appear to enhance the transmission of HA in human connective tissue; therefore, use of phonophoresis should be reconsidered in inflammatory conditions.
authors.forename: A Burke
authors.initials: AB
authors.lastname: Gurney
authors.forename: Daniel
authors.initials: D
authors.lastname: Wascher
authors.forename: Robert
authors.initials: R
authors.lastname: Schenck
authors.forename: Alexandria
authors.initials: A
authors.lastname: Tennison
authors.forename: Bettina
authors.initials: B
authors.lastname: Jaramillo