Effects of low-intensity pulsed ultrasound therapy on fracture healing.
On Monday, we posted that therapeutic ultrasound in ankle sprains was no better than placebo/ sham. This systematic review and meta-analysis was performed to identify the clinical trials relevant to the effects of low-intensity pulsed ultrasound (LIPUS) on bone regeneration.
Five electronic databases were searched to identify the relevant studies on the effects of LIPUS on bone healing. The inclusion criteria were human clinical trial, all types of bones, fractures, and outcome measurements, LIPUS application, and English language. 260 potentially eligible abstracts were identified and 23 met the inclusion criteria. These were critically appraised by two raters independently using the PEDro appraisal tool. The results of all eligible studies were categorized into three groups: fresh fractures, delayed or nonunions, and distraction osteogenesis.
Seven fresh fracture trials were identified as eligible for meta-analysis because of the homogeneity of outcome measurements and clinical situations. The time of the third cortical bridging (increase in density or size of initial periosteal reaction) in radiographic healing was the common criteria for the meta-analysis.
The time of third cortical bridging was statistically earlier following LIPUS therapy in fresh fractures. LIPUS can stimulate radiographic bone healing in fresh fractures. Although there is weak evidence that LIPUS also supports radiographic healing in delayed unions and non-unions, it was not possible to pool the data because of a paucity of sufficient studies with similar outcome measures. > From: Bashardoust et al., Am J Phys Med Rehabil 91 (2012) 349-367. All rights reserved to Lippincott, Williams & Wilkins.