Guidelines Recommend Against Low-Intensity Pulsed Ultrasound for Bone Fractures
An expert panel released recommendations against the use of low-intensity pulsed ultrasound (LIPUS) for accelerating the recovery of bone fractures or osteotomy in adults and children.
LIPUS was approved for fracture healing in 1994 by the US Food and Drug Administration and recommended by the UK National Institute for Health and Care Excellence in 2010 for reducing fracture healing time, particularly for patients experiencing delayed healing and non-union.
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An international panel of orthopedic and musculoskeletal trauma surgeons, physiotherapists, general internists, methodologists, and patients examined evidence from 26 trials, which included a total of 1565 patients who were randomly assigned to LIPUS, sham, or no device. Panelists determined the strength of the recommendation based on the efficacy of LIPUS to reduce pain and accelerate functional recovery in patients, such as time to return to work and time to full weight bearing.
Based on the systematic review, the panelists found no evidence supporting the ability of LIPUS to reduce time to work, time to full weight bearing, and pain in patients.
“We have moderate to high certainty of a lack of benefit for outcomes important to patients, and, combined with the high costs of treatment, LIPUS represents an inefficient use of limited healthcare resources,” the panelists wrote.
The guidelines recommend that researchers focus on other interventions for speeding up recovery and reducing pain from fractures, as the panelists state it is unlikely that new evidence will alter their recommendations regarding LIPUS.
—Melissa Weiss
Reference:
Poolman RW, Agoritsas T, Siemieniuk RAC, et al. Low intensity pulsed ultrasound (LIPUS) for bone healing: a clinical practice guideline [published online February 21, 2017]. BMJ. doi:https://doi.org/10.1136/bmj.j576.