Popular ultrasound therapy does not improve fracture healing

Release date: 2016-10-27

A large international study led by McMaster University researchers showed that low-intensity ultrasound is a common treatment after surgical repair of fractures, which can improve recovery, but it does not work.

 

A clinical trial published today in the "BMJ" magazine, researchers there was no difference in the use of low-intensity pulsed ultrasound (LIPUS) and placebo in patients with tibial fractures terms of recovery time.

 

An accompanying editorial published today shows that it is time to give up this ineffective treatment, and there is now strong evidence that it does not work.

 

Principal investigator Jason Busse said: "Low-intensity pulsed ultrasound is commonly used in North America to accelerate fracture healing, generating approximately $ 250 million in annual sales , but there is no clear evidence to support its effectiveness . "

 

Busse is an associate professor of anesthesiology and a researcher at the Michael DeGroot School of Medicine and Institute of Pain and Nursing.

 

Low-intensity pulsed ultrasound by the US Food and Drug Administration (FDA) in 1994 approved for fracture healing. Interventions for assisted recovery are common for tibial fractures because this common fracture healing is slow and usually requires further surgery to complete healing.

 

The International Research Group conducted a randomized controlled trial of 501 patients at 43 academic trauma centers in North America. From 2008 to 2012 , they underwent surgical repair of the tibia (calf) fracture. Patients were assigned a 20- minute daily treatment using low-intensity pulsed ultrasound or a seemingly identical placebo device. Everyone involved, including doctors, data collectors, data analysts, and patients, does not know which treatment to use. The patient is followed until the x -ray shows fracture healing.

 

There was no time difference in functional recovery, whether it was treated with an active or placebo device. There is no difference in the quality of life, work recovery, leisure activities or full weight-bearing time.

 

Co-Chair Investigator Mohit Bhandari, a professor of surgery at McMaster , points to the importance of ensuring evidence support for medical devices.

 

Bhandari, chairman of Canadian evidence-based medicine research, said : "Low-intensity pulsed ultrasound is approved for fracture healing based on small trials. These trials have important limitations. They focus on radiographic treatment rather than the patient's important outcome. " .

 

The new trial results show that low-intensity pulsed ultrasound has no effect in managing surgery for patients with fractures.

 

Xavier Griffin, associate professor of traumatology at Oxford University, said: "In the editor of BMJ , the results are clear."

 

He said: "These authors report important patient-centered results, suggesting that low-intensity pulsed ultrasound has no benefit for adult tibiofibular fractures." Now is the time for us to make full use of their determination to give up this ineffective treatment.

Source: Noble

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