Focused Ultrasound Therapy
Focused ultrasound is a 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.
There are multiple targets that can be treated. This section gives overall information, but please see the subheadings in this article for more details on knee, hip, hand, and sacroiliac joint. There is also a separate section on back pain. For many types of arthritis, the option of joint replacement is considered. Unfortunately, even with a quality primary joint replacement, the new 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 in delaying the timing of the primary joint replacement, may eliminate the need for a revision surgery. A recent study has begun using neuroimmune modulation to treat patients with rheumatoid arthritis.
Advantages
The primary options for treatment of 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.
Hand
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.
Knee
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.
Hip
Hip 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.
Rheumatoid Arthritis
Localized therapy with immune modulation is being evaluated to see if this can improve the status of patients with rheumatoid arthritis.
Sacroiliac
This is similar to the treatment for facetogenic arthritis in the back, where the FUS Mobile system targets and uses focused ultrasound to ablate the responsible nerves.
Clinical Trials
A clinical trial is using neuroimmune modulation to treat patients with rheumatoid arthritis.
A clinical trial in Canada is looking at using focused ultrasound to improve symptoms in patients with arthritis in the knee.
A clinical trial is using focused ultrasound to treat patients who have a variety of inflammatory forms of arthritis.
A clinical trial at UVA is using the FUS mobile system for the treatment the nerves that carry pain from sacroiliac arthritis.
The Foundation updates these pages regularly, but with the increasing number of clinical trials, we want to be sure that our audience has the latest information available. Therefore, we also added the website search information for the above trials. If you click here, it will take you to the latest information available from https://www.clinicaltrials.gov/.
Notable Papers
Sassi R, Gazzotti S, Aparisi Gómez MP, Donati CM, Morganti AG, Weber MA, Ghanouni P, Napoli A, Bazzocchi A. Focused ultrasound-mediated drug delivery systems: a technological overview, possible musculoskeletal applications, and future directions. [Original Title: Verabreichung von Medikamenten mittels fokussierten Ultraschalls: ein technologischer Überblick, mögliche Anwendungen am Bewegungsapparat und weitere Perspektive.] Rofo. 2026 Jan 30. doi: 10.1055/a-2760-5392. PMID: 41617152
Ilfeld BM, Cao KN, Branson R, Bloom P. Ultrasound Neuromodulation (Low-Intensity Focused Ultrasound) to Treat Knee Osteoarthritis Pain: A Randomized, Observer- and Participant-Masked, Sham-Controlled, Human-Subjects Pilot Study. J Ultrasound Med. 2025 Sep;44(9):1713-1721. doi: 10.1002/jum.16706. Epub 2025 Apr 17. PMID: 40241493
Tiegs-Heiden CA, Long Z, Lu A, Gorny KR, Hesley GK. Osteoarthritis-related knee pain: MRI-guided focused ultrasound ablation treatment. Int J Hyperthermia. 2025 Dec;42(1):2451686. doi: 10.1080/02656736.2025.2451686. Epub 2025 Jan 19. PMID: 39828268
Hu HY, Sun YJ, Yuan XF, Han JF, Liao TT, Zhang FY, Mao JD, Zhang L, Ye WL. Ultrasound-controllable dexamethasone-loaded nanobubbles for highly effective rheumatoid arthritis therapy. J Mater Chem B. 2025 Jan 6. doi: 10.1039/d4tb01120a. PMID: 39757977
Beckmann NM, Villamaria EE. Interventional Therapies for Osteoarthritis: An Update. AJR Am J Roentgenol. 2022 Jun 22. doi: 10.2214/AJR.22.27548. PMID: 35731097
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.
He X, Chen H, Chang S, Zhu S. Multifunctional Nanoparticles Co-Loaded with Perfluoropropane, Indocyanine Green, and Methotrexate for Enhanced Multimodal Imaging of Collagen-Induced Arthritis. Mol Pharm. 2022 Apr 28. doi: 10.1021/acs.molpharmaceut.2c00174. PMID: 35484086
Wu H, He Y, Wu H, Zhou M, Xu Z, Xiong R, Yan F, Liu H. Near-infrared fluorescence imaging-guided focused ultrasound-mediated therapy against Rheumatoid Arthritis by MTX-ICG-loaded iRGD-modified echogenic liposomes. Theranostics 2020; 10(22):10092-10105. doi:10.7150/thno.44865.
Song BW, Park JH, Kim B, Lee S, Lim S, Kim SW, Choi JW, Lee J, Kang M, Hwang KC, Chae DS, Kim IK. A Combinational Therapy of Articular Cartilage Defects: Rapid and Effective Regeneration by Using Low-Intensity Focused Ultrasound After Adipose Tissue-Derived Stem Cell Transplantation. Tissue Eng Regen Med. 2020 Apr 9. doi: 10.1007/s13770-020-00256-6.
Tiegs-Heiden CA, Lehman VT, Gorny KR, Boon AJ, Hesley GK. Improved Treatment Response Following Magnetic Resonance Imaging-Guided Focused Ultrasound for Lumbar Facet Joint Pain. Mayo Clin Proc Innov Qual Outcomes. 2019 Dec 28;4(1):109-113. doi: 10.1016/j.mayocpiqo.2019.10.003. eCollection 2020 Feb.
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.
Nieminen HJ, Lampsijärvi E, Barreto G, Finnilä MAJ, Salmi A, Airaksinen AJ, Eklund KK, Saarakkala S, Pritzker KPH, Hæggström E. Localized delivery of compounds into articular cartilage by using high-intensity focused ultrasound. Sci Rep. 2019 Nov 4;9(1):15937. doi: 10.1038/s41598-019-52012-z
Cotero V, Graf J, Zachs DP, Tracey KJ, Ashe J, Lim HH, Puleo C. Peripheral Focused Ultrasound Stimulation (pFUS): New Competitor in Pharmaceutical Markets? SLAS Technol. 2019 Jun 17:2472630319849383. doi: 10.1177/2472630319849383.
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.
Click here for additional references from PubMed.