title: Do the Effects of Transcutaneous Electrical Nerve Stimulation on Knee Osteoarthritis Pain and Function Last?
abstract: Transcutaneous electrical nerve stimulation (TENS) has been shown to decrease pain associated with knee osteoarthritis, which potentially leads to better function, improved quality of life, and postpones the need for surgical intervention. The purpose of this study was to perform a 1-year follow-up of a previous prospective group of patients with knee osteoarthritis, randomized to TENS or standard of care, who were asked to rate their changes in: (1) patient pain perception; (2) subjective medication use; (3) subjective functional abilities; (4) quality of life; (5) device use; and (6) conversion to TKA. A population of 70 patients were randomized to receive either a TENS device or a standard conservative therapy regimen. Patients were evaluated based on various subjective outcomes at minimum 1-year (mean, 19 months) follow-up. The TENS cohort had lower visual analog pain scores compared with the matching cohort. Subjective functional outcomes, as well as functional and activity scores, were also greater in the TENS cohort. Patients in TENS cohort showed significant improvements in their subjective and functional outcomes as compared with their initial status, while the control group did not show significant change. A majority of the TENS patients were able to reduce the amount of pain medications. Additionally, a large portion of the patients assigned to the TENS group continue to use the device, after completion of the trial. This study demonstrated the benefit of TENS for improving subjective outcomes in patients with pain due to knee osteoarthritis, compared with standard conservative treatments. The results of the study suggest that TENS is a safe and effective adjunct as part of the spectrum of current nonoperative treatment methods for knee osteoarthritis.
authors.affiliation: Rubin Institute for Advanced Orthopaedics, Center for Joint Preservation and Replacement, Baltimore, Maryland.
authors.forename: Jeffrey Jai
authors.initials: JJ
authors.lastname: Cherian
authors.affiliation: Rubin Institute for Advanced Orthopaedics, Center for Joint Preservation and Replacement, Baltimore, Maryland.
authors.forename: Paige E
authors.initials: PE
authors.lastname: Harrison
authors.affiliation: Department of Physical Medicine and Rehabilitation, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors.forename: Samantha A
authors.initials: SA
authors.lastname: Benjamin
authors.affiliation: Department of Physical Medicine and Rehabilitation, Sinai Hospital of Baltimore, Baltimore, Maryland.
authors.forename: Anil
authors.initials: A
authors.lastname: Bhave
authors.affiliation: Department of Orthopaedic Surgery, Beth Israel Medical Center, New York, New York.
authors.forename: Steven F
authors.initials: SF
authors.lastname: Harwin
authors.affiliation: Rubin Institute for Advanced Orthopaedics, Center for Joint Preservation and Replacement, Baltimore, Maryland.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Mont
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D018771:Arthralgia / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000503:physiopathology / Q000628:therapy*; D010147:Pain Measurement; D011446:Prospective Studies; D011788:Quality of Life; D020127:Recovery of Function; D013997:Time Factors; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D000894:Anti-Inflammatory Agents, Non-Steroidal