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.
There are multiple targets that can be treated. This section gives overall information, but please see specific entries for arthritis of the knee, hip, hand, and sacroiliac joint as well as the 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.
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.
A clinical trial in Taiwan is looking at treating facet arthritis causing low back pain with focused ultrasound.
A multi-center clinical trial in Canada is evaluating the safety and efficacy of a focused ultrasound device to treat back pain secondary to facet joint arthritis. This study is only open to Canadian residents.
Regulatory Approval and Reimbursement
The Insightec magnetic resonance-guided focused ultrasound system has been approved in Europe and Russia for the treatment of back pain secondary to facet joint arthritis.
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.
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.