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Ultrasound treatment does not help in fracture healing

Low intensity ultrasound after surgical repair of a bone fracture, is a popular treatment to progress recovery, but it does not work, found a large international study led by researchers at McMaster University.

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Description

  • In a clinical trial, the researchers showed no difference in the recovery time when using low intensity pulsed ultrasound (LIPUS) or a placebo device, for patients with a fractured tibia (shinbone).
  • An accompanying editorial, also published today, suggests “it is time to abandon this ineffective treatment” now that there is strong evidence it doesn’t work.
  • Principal investigator Jason Busse said, “LIPUS is commonly used in North America to accelerate fracture healing — generating about $250 million in sales a year – but there has been no clear evidence of benefit to support its use.”
  • LIPUS was approved for fracture healing by the U.S. Food and Drug Administration (FDA) in 1994.
  • Interventions to aid recovery have been popular for tibia fractures since this common fracture heals slowly and often needs further surgery to heal completely.
  • The international research team conducted a randomized controlled trial of 501 patients at 43 academic trauma centers in North America who underwent surgical repair for a tibia (lower leg) fracture between 2008 and 2012.
  • The patients were assigned 20-minute daily treatment with either a LIPUS or a placebo device which looked the same.
  • Everyone involved, including the physicians, data collectors, data analysts and the patients were blind to which treatment was used.
  • Patients were followed until x-rays showed their fracture was healed, or for 12 months.
  • There was no difference in time to functional recovery whether patients were treated with the active or placebo device.
  • There was also no difference in quality of life, return to work, leisure activities, or time to full weight-bearing.
  • Co-principal investigator Mohit Bhandari, pointed out the importance of ensuring medical devices are supported by evidence.
  • “LIPUS was approved for fracture healing on the basis of small trials that had important limitations, and they focussed on radiographic healing instead of patient important outcomes,” said Bhandari.
  • “The new trial results establish that LIPUS has no role in managing patients with surgically repaired fractures,” he added.

Tags

Ultrasound treatment, fracture healing

References

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