Comparison of the effects of topical hydrocortison and clobetasole phonophoresis on reduction of pain in osteoarthritic knee joint

Introduction: Phonophoresis is the use of ultrasound to enhancing cellular drug delivery through the skin. In this study the effect of clobethasole and hydrocortisone ointments phonophoresis on pain, knee osteoarthritis and some other symptoms was studied. Methods: An experimental single blind randomized clinical trial (RCT) was used. An available sampling technique was used for selection of patients. Sixty subjects with osteoarthritic knee (tibiofemoral) joints were randomly assigned to six groups: 1-Ultrasound with acoustic gel. 2- Placebo ultrasound with hydrocortisone. 3- Placebo ultrasound with clobetasole. 4- Hydrocortisone phonophoresis. 5- Clobetasole phonophoresis. 6- Placebo ultrasound with acoustic gel. All of the patients received treatments for ten sessions. Pain level was determined by visual analog scale (VAS) at the beginning, day 6 and follow up day (11th session). Edema and knee range of motion (ROM) were measured at the beginning, day 4, day 7 and follow up day. 20 meters walking test time was measured at the beginning and follow up day. Wilcoxon and Friedman statistical tests were used to analyze data. Results: At the end of treatment sessions groups 1, 4, 5 showed a significant decrease in pain and edema and an increase in knee ROM and 20 meters walking test time (P < 0.05). Additionally, there was a significant difference in improvement rates between group 5 and groups 1 and 4.. Conclusion: This study showed that both hydrocortisone and clobetasole phonophoresis were more effective than ultrasound and acoustic gel on osteoarthritic pain of knee joint. Clobetasole has a faster effect than other treatments.