Health Problem: Knee osteoarthritis (KOA) develops via progressive destruction of the cartilage lining the knee joints, subchondral bone surfaces, and synovium. KOA causes pain, immobility, muscle weakness, decreased function, and impaired ability to complete activities of daily living. Symptomatic KOA has a prevalence rate of 12% in adults aged 60 years or greater. KOA negatively impacts quality of life and it is the primary indication for total knee arthroplasty.
Technology Description: Transcutaneous electrical nerve stimulation (TENS) devices comprise a small, programmable, electronic stimulus generator and ≥ 1 pairs of electrodes that are placed directly on the skin, usually via adhesive pads, to deliver pulsed electrical stimulation of modifiable frequency, intensity, and duration.
Controversy: The difficulty in managing the pain and disability caused by KOA have led clinicians and patients to try a wide range of nonsurgical options, including various types of electrical stimulation. Since its introduction in the early 1970s, the use of TENS has spread widely despite inconsistencies and gaps in the evidence supporting its use.
Key Questions:
- Is TENS effective for reducing pain and improving function in adults with KOA?
- Is TENS safe in adults with KOA?
- Have definitive patient selection criteria been identified for TENS in adults with KOA?
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