J Knee Surg 2015; 28(04): 321-328
DOI: 10.1055/s-0034-1389160
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Use of Transcutaneous Electrical Nerve Stimulation Device in Early Osteoarthritis of the Knee

Jeffrey J. Cherian
1  Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
,
Bhaveen H. Kapadia
1  Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
,
Anil Bhave
1  Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
,
Mark J. McElroy
1  Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
,
Christopher Cherian
1  Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
,
Steven F. Harwin
2  Department of Orthopaedic Surgery, Beth Israel Medical Center, New York, New York
,
Michael A. Mont
1  Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, Maryland
› Author Affiliations
Further Information

Publication History

25 April 2014

13 July 2014

Publication Date:
27 August 2014 (eFirst)

Abstract

Some have proposed the use of transcutaneous electrical nerve stimulation (TENS) as an adjunct to the current standard of care in treatment of osteoarthritis knee pain. The purpose of this study was to evaluate the effects of TENS on the following issues in patients who have early-stage osteoarthritis of the knee: (1) pain reduction; (2) subjective and (3) objective functional improvements; (4) quality-of-life (QOL) measure improvements; and (5) isokinetic strength. A prospective, randomized, and single-blinded trial was performed on 23 patients who were randomized to either novel TENS device or standard of care. Metrics analyzed included stair-climb test; timed-up-and-go test (TUGT); 2-minute walk test; 20 times, single leg 6-inch step test; five-repetition chair-rise test; active and passive range-of-motion (ROM) score; short form health survey–36 scores (SF-36) score; Knee Society Score (KSS); lower extremity functional scale (LEFS); visual analog scale (VAS); and isokinetic quadriceps and hamstring strength. In objective functional scores, TENS had significant improvements in TUGT and objective KSS when compared with the matching cohort. Subjective functional and QOL outcomes patients had a significant improvement of their LEFS and SF-36 physical component with the use of TENS brace. The TENS device significantly improved the quadriceps strength when compared with standard therapy. In evaluation for improvement within the TENS cohort, patients had a significant improvement at 3-month follow-up in the TUG test, timed stair-climb test, 20-times single leg, KSS, LEFS, and SF-36 physical component compared to their initial visit. In addition, within the TENS cohort, patients had a significant reduction in pain via VAS at their 3-month follow-up. In conclusion, the use of TENS for 3 months has shown encouraging results to improve pain, function, and QOL in patients with painful osteoarthritic knees, and could positively contribute as an adjunct to current nonoperative treatment of knee arthritis. However, given our small sample size, larger randomized studies are needed to further evaluate these outcomes.