Pulsed Low-Intensity Ultrasound

Gebauer, D; Correll, J.

doi:10.1097/01.bpo.0000173245.12184.7e

Cited by 49 publications

(12 citation statements)

References 27 publications

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“…Beyond modulation of growth factors and cell delivery, low-intensity pulsed ultrasound (LIPUS) has been utilized extensively to promote healing in animal and clinical models of fractures, non-unions, and distraction osteogenesis 5,11,27–29,35,38 . LIPUS is based on the theory that acoustic pressure waves are transmitted through the body by molecular vibrations and collisions 49 .…”

Section: Vascularization In Bone Repairmentioning

confidence: 99%

“…LIPUS is based on the theory that acoustic pressure waves are transmitted through the body by molecular vibrations and collisions 49 . Numerous clinical studies have shown that 20 minutes of LIPUS therapy per day can reduce the time to fracture healing by 17–51%, and are associated with nonunion healing rates of approximately 85%, which are equivalent to surgical intervention rates 11,27,28,35,38 . Although the exact mechanism of LIPUS on fracture healing is not well understood, in vitro and in vivo studies have suggested that it upregulates VEGF expression in osteoblast and periosteal cells 22,55 , as well as increasing aggrecan and proteoglycan synthesis in chondrocytes 63,70,92 .…”

Section: Vascularization In Bone Repairmentioning

confidence: 99%

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Angiogenesis in bone regeneration

Hankenson

Dishowitz

Gray

et al. 2011

Injury

441

325

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Angiogenesis is a key component of bone repair. New blood vessels bring oxygen and nutrients to the highly metabolically active regenerating callus and serve as a route for inflammatory cells and cartilage and bone precursor cells to reach the injury site. Angiogenesis is regulated by a variety of growth factors, notably vascular endothelial growth factor (VEGF), which are produced by inflammatory cells and stromal cells to induce blood vessel in-growth. A variety of studies with transgenic and gene-targeted mice have demonstrated the importance of angiogenesis in fracture healing, and have provided insights into regulatory processes governing fracture angiogenesis. Indeed, in animal models enhancing angiogenesis promotes bone regeneration, suggesting that modifying fracture vascularization could be a viable therapeutic approach for accelerated/improved bone regeneration clinically.

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Section: Vascularization In Bone Repairmentioning

confidence: 99%

Section: Vascularization In Bone Repairmentioning

confidence: 99%

Angiogenesis in bone regeneration

Hankenson

Dishowitz

Gray

et al. 2011

Injury

441

325

View full text Add to dashboard Cite

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“…151921 The study with the highest level of evidence (the double-blinded RCT) reported a healing rate of 100% of 21 scaphoid nonunions with an average fracture age of 38.4 months. A healing rate of 86% was reported by the study with the largest sample size (366 nonunions) 20.…”

Section: Resultsmentioning

confidence: 99%

Low-intensity pulsed ultrasound: Nonunions

2009

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Nonunions occur in 5–10% of fractures and are characterized by the failure to heal without further intervention. Low intensity pulsed ultrasound therapy has been developed as an alternative to surgery in the treatment of nonunions. We describe a systematic review on trials of low-intensity pulsed ultrasound therapy for healing of nonunions. We searched the electronic databases Medline and the Cochrane library for articles on ultrasound and healing of nonunions published up to 2008. Trials selected for the review met the following criteria: treatment of at least one intervention group with low intensity pulsed ultrasound; inclusion of patients (humans) with one or more nonunions (defined as “established” or as a failure to heal for a minimum of eight months after initial injury); and assessment of healing and time to healing, as determined radiographically. The following data were abstracted from the included studies: sample size, ultrasound treatment characteristics, nonunion location, healing rate, time to fracture healing, fracture age, and demographic information. We found 79 potentially eligible publications, of which 14 met our inclusion criteria. Of these, eight studies were used for data abstraction. Healing rates averaged 87%, (range 65.6%-100%) among eight trials. Mean time to healing was 146.5 days, (range 56-219 days). There is evidence from trials that low-intensity pulsed ultrasound may be an effective treatment for healing of nonunions. More homogeneous and larger controlled series are needed to further investigate its efficacy.

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“…In addition, an increase in insulin-like growth factor in bone marrow-derived stromal cells [17] and an increase in prostaglandin E2 production in osteoblasts have been observed [18]. Recently, LIPUS was used for treatment of Charcot joint and leg lengthening [19-21]. In Alagille syndrome, deficiency of intestinal bile acids ultimately interferes with the absorption of vitamin D, and failure of endochondral ossification is generally associated with the disturbance of absorption of vitamin D. However, the underlying mechanism causing delayed union in Alagille syndrome remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Pathological fracture of the femur in Alagille syndrome that was treated with low-intensity pulsed ultrasound stimulation and an Ilizarov ring fixator: a case report

Nozaka

Shimada

Miyakoshi

et al. 2014

BMC Musculoskelet Disord

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BackgroundAlagille syndrome is a multisystem disorder, which is characterized by hypoplasia of the intrahepatic bile ducts, malformations of the cardiovascular system, eyes, and vertebral column, and abnormal facies. Several of the characteristics of Alagille syndrome may result in an especially high risk of fracture. The majority of patients suffer from chronic cholestasis, which can have a variety of adverse effects on bone metabolism. In Alagille syndrome, fractures primarily occur in the lower limb long bones in the absence of significant trauma.Case presentationA 9-year-old Japanese girl with Alagille syndrome was admitted to our institution with marked hyperbilirubinemia and a pathological fracture of the femur. She had been diagnosed with biliary atresia at the age of 1 month and treated with surgical bile duct reconstruction, vitamins D and K, and ursodeoxycholic acid. However, her liver dysfunction and hyperbilirubinemia worsened. The pathological fracture of the femur was treated with low-intensity pulsed ultrasound stimulation (LIPUS) and an Ilizarov ring fixator. Seventy-four days after surgery, the patient had anatomically and functionally recovered. There was no leg-length discrepancy and no angular malalignment of the lower extremities as measured clinically and radiographically. The range of motion of the hip, knee, and ankle of the patient’s operative leg matched the range of motion in the nonoperative leg.ConclusionTo the best of our knowledge, there are no reports on use of the Ilizarov frame and LIPUS in diaphyseal femoral fractures in Alagille syndrome. This case report provides evidence that this procedure is successful for managing such diaphyseal fractures in Alagille syndrome.

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Pulsed Low-Intensity Ultrasound

Cited by 49 publications

References 27 publications

Angiogenesis in bone regeneration

Angiogenesis in bone regeneration

Low-intensity pulsed ultrasound: Nonunions

Pathological fracture of the femur in Alagille syndrome that was treated with low-intensity pulsed ultrasound stimulation and an Ilizarov ring fixator: a case report

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