Millimetre wave therapy for pain relief after total knee arthroplasty: A randomised controlled trial

Abstract

Millimetre wave therapy (MWT) is a promising complementary method for pain relief, however rigorous investigations of its effectiveness are needed. The purpose of this study was to examine if MWT can reduce opioid requirement compared to sham procedure applied for relief of acute pain in patients after total knee arthroplasty (TKA). Eighty patients undergoing TKA were randomly assigned to receive MWT or sham procedure. Patients and evaluators were blinded to the group allocation. MWT consisted of six sessions, each session of 30 min duration. During each session the knee wound was exposed to electromagnetic waves with frequency 50-75 GHz and power density 4.2 mW/cm(2). Postoperative analgesia with piritramide, a weak opioid with 0.7 potency of morphine delivered via patient-controlled analgesia pump, was directed to achieve pain intensity of less than 40 on a 100 mm visual analogue scale (VAS). The primary outcome measure was postoperative piritramide requirement for three days after surgery. Secondary outcome measures were: total ibuprofen requirement from the fourth postoperative day to discharge; success of patients' blinding; patients' satisfaction with pain relief; incidence of analgesia-related side effects; heart rate and blood pressure. Piritramide requirement was similar in both groups whereby all patients reported adequate pain relief measured on a VAS. Secondary outcome measures were also comparable in both groups. The majority of patients in both groups believed they had received true MWT and wanted to repeat it in future. Millimetre waves applied to surfaces of surgical wounds did not reduce opioid requirement compared to the sham procedure after TKA.

Millimeter wave treatment induces apoptosis via activation of the mitochondrial-dependent pathway in human osteosarcoma cells

“…For the extrinsic pathway, death signals are mediated through cell surface receptors. Both pathways eventually lead to the activation of caspases and nucleases, resulting in the destruction of the cell (13,14,17). Our experimental results showed that apoptotic cells induced by MW displayed condensed and fragmented nuclei by Hoechst 33258 staining (Fig.…”

“…Millimeter wave treatment is a physiotherapy, which has been demonstrated to be clinically effective in treating various types of diseases including cancers (13,14). However, the mode of action for its anti-tumor is still largely unknown.…”

“…These problems highlight the urgent need for the development of novel cancer chemotherapies. Since physiotherapy, such as millimeter wave (MW), have relatively fewer side-effects as compared to modern chemotherapeutics and have long been used clinically to treat various types of diseases including cancer (13,(36)(37)(38), finding that naturally occurring agents with pro-apoptotic activities is a promising approach for anti-cancer treatment.…”

“…In turn, the energy can interfere with signal transduction and affect metabolism (8)(9)(10). It has been shown that a millimeter wave can evoke multiple biological effects (11,12) and is useful in the treatment of various types of diseases including cancers, such as hepatic cellular cancer patient (13,14). However, the effects of MW on the growth and apoptosis of human osteosarcoma U-2OS cells,…”

Acupuncture for analgesia in the emergency department: a multicentre, randomised, equivalence and non‐inferiority trial

“…There was no difference in postoperative analgesic requirements following use of millimetre wave therapy after total knee arthroplasty (Usichenko, Edinger et al, 2008 Level II) or healing touch after coronary artery bypass surgery (MacIntyre et al, 2008 Level II), although postoperative anxiety was significant reduced in the latter study.…”