Focused Ultrasound Therapy
Focused ultrasound is an early-stage, noninvasive, therapeutic technology with the potential to improve the quality of life and decrease the cost of care for patients with arthritis. This novel technology focuses beams of ultrasound energy precisely and accurately on targets in the body without damaging surrounding normal tissue.
How it Works
Where the beams converge, the ultrasound produces precise ablation (thermal destruction of tissue) enabling the nerves that carry painful signals from arthritis to be treated without surgery.
A recent clinical trial was completed in Japan and revealed that MRgFUS ablation was both safe and effective at treating chronic pain caused by medial knee arthritis.
Knee arthritis is a common condition, and for many the option of joint replacement is considered. Unfortunately, even with a quality primary joint replacement, the replacement joints do wear out, raising the need for a revision joint replacement (a second procedure on a previously replaced joint). The revision surgery is a much more difficult task than a primary one. The use of focused ultrasound to delay the timing of the primary joint replacement, may eliminate the need for a revision surgery.
This technique is also helpful as some patients are not candidates for surgical joint replacement.
The primary options for treatment of knee arthritis include medication and invasive surgery.
For certain patients, focused ultrasound could provide a noninvasive alternative to surgery with less risk of complications – such as surgical wound healing or infection – at a lower cost. It can reach the desired target without damaging surrounding tissue and is repeatable, if necessary.
At the present time, there are no clinical trials recruiting patients with knee pain for focused ultrasound therapy.
Regulatory Approval and Reimbursement
Focused ultrasound treatment for arthritis is not yet approved by regulatory bodies or covered by medical insurance companies.
Kawasaki M, Muramatsu S, Namba H, Izumi M, Ikeuchi M, Yaogawa S, Morio K, Ushida T. Efficacy and safety of magnetic resonance-guided focused ultrasound treatment for refractory chronic pain of medial knee osteoarthritis. Int J Hyperthermia. 2021 Sep;38(2):46-55. doi: 10.1080/02656736.2021.1955982.
Namba H, Kawasaki M, Izumi M, Ushida T, Takemasa R, Ikeuchi M. Effects of MRgFUS Treatment on Musculoskeletal Pain: Comparison between Bone Metastasis and Chronic Knee/Lumbar Osteoarthritis. Pain Res Manag. 2019 Sep 2;2019:4867904. doi: 10.1155/2019/4867904. eCollection 2019.
Scipione R, Anzidei M, Bazzocchi A, Gagliardo C, Catalano C, Napoli A. HIFU for Bone Metastases and other Musculoskeletal Applications. Semin Intervent Radiol. 2018 Oct;35(4):261-267. doi: 10.1055/s-0038-1673363. Epub 2018 Nov 5.
Izumi M, Ikeuchi M, Kawasaki M, Ushida T, Morio K, Namba H, Graven-Nielsen T, Ogawa Y, Tani T. MR-guided focused ultrasound for the novel and innovative management of osteoarthritic knee pain. BMC Musculoskelet Disord. 2013 Sep 13;14:267. doi: 10.1186/1471-2474-14-267.
Weeks EM, Platt MW, Gedroyc W. MRI-guided focused ultrasound (MRgFUS) to treat facet joint osteoarthritis low back pain–case series of an innovative new technique. Eur Radiol. 2012 Dec;22(12):2822-35. doi: 10.1007/s00330-012-2628-6. Epub 2012 Aug 31.