Dataset Information

The effects of low-intensity pulsed ultrasound on fresh fracture: A meta-analysis.

ABSTRACT:

Background

Low-intensity pulsed ultrasonography (LIPUS) is a form of mechanical stimulation that is delivered via a special device to the fracture site for the acceleration of fracture healing. We conducted a meta-analysis to assess the effect of LIPUS for fresh fractures in adults.

Methods

MEDLINE, EMBASE and the Cochrane Library searched between Jan 1980 and Nov 2016. Studies should be quasi-randomized and randomized controlled trials (RCTs) comparing treatment with LIPUS to placebo or no treatment in adults with fresh fractures, reporting outcomes such as function; time to union; delayed union or non-union. Summary standard mean difference (SMD) and the risk ratio (RR) with their 95% confidence interval (CI) calculated with a random effects model. I statistic was used to assess the heterogeneity. Risk of bias was assessed by the Cochrane risk-of-bias tool. The GRADE system was used to evaluate the evidence quality.

Results

A total of 12 trials with 1099 patients were included. The pooled results showed that LIPUS significantly reduced the time to fracture union (SMD: 0.65, 95% CI: 1.13 to 0.17), improved the quality of life (SMD: 0.20, 95% CI: 0.03-0.37) without affecting the time to full weight bearing (SMD: 0.76, 95% CI: 1.92 to 0.4), the time to return to work (SMD: 0.06, 95% CI: 0.14 to 0.27), or the incidence rate of delayed union and nonunion (RR: 1.02, 95% CI: 0.60-1.74).

Conclusions

Moderate-to-high quality evidence shows that LIPUS treatment reduces the time to fracture union and improves the quality of life without affecting functional recovery and incident rate of delayed union and nonunion, suggesting that LIPUS treatment may be a good treatment modality for adults with fresh fractures. However, there are some methodological limitations in the eligible trials, further studies are needed to determine the clinical circumstances under which LIPUS is truly valid and to examine the optimal approach for the use of this adjunctive therapy.

SUBMITTER: Lou S

PROVIDER: S-EPMC5626319 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Publications

The effects of low-intensity pulsed ultrasound on fresh fracture: A meta-analysis.

Lou Shenghan S Lv Houchen H Li Zhirui Z Zhang Licheng L Tang Peifu P

Medicine 20170901 39

<h4>Background</h4>Low-intensity pulsed ultrasonography (LIPUS) is a form of mechanical stimulation that is delivered via a special device to the fracture site for the acceleration of fracture healing. We conducted a meta-analysis to assess the effect of LIPUS for fresh fractures in adults.<h4>Methods</h4>MEDLINE, EMBASE and the Cochrane Library searched between Jan 1980 and Nov 2016. Studies should be quasi-randomized and randomized controlled trials (RCTs) comparing treatment with LIPUS to pla ...[more]

PMID: 28953676

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Project description:BACKGROUND:Low-intensity pulsed ultrasound (LIPUS) is a common adjunct used to promote bone healing for fresh fractures and non-unions, but its efficacy for bone distraction osteogenesis remains uncertain. This study aims to determine whether LIPUS can effectively and safely reduce the associated treatment time for patients undergoing distraction osteogenesis. METHODS:MEDLINE, EMBASE, and the Cochrane Library were searched until May 1, 2018, without language restriction. Studies should be randomized controlled trials (RCTs) or quasi-RCTs of LIPUS compared with sham devices or no devices in patients who undergo distraction osteogenesis. The primary outcome was the treatment time. The secondary outcome was the risk of complications. Treatment effects were assessed using mean differences, standardized mean differences, or risk ratios using a random-effects model. The Cochrane risk-of-bias tool was used to assess the risk of bias. The I2 statistic was used to assess the heterogeneity. The GRADE system was used to evaluate the evidence quality. RESULTS:A total of 7 trials with 172 patients were included. The pooled results suggested that during the process of distraction osteogenesis, LIPUS therapy did not show a statistically significant reduction in the treatment time (mean difference, -?8.75 days/cm; 95% CI, -?20.68 to 3.18 days/cm; P?=?0.15; I2?=?72%) or in the risk of complications (risk ratio, 0.90 in favor of LIPUS; 95% CI, 0.65 to 1.24; I2?=?0%). Also, LIPUS therapy did not show a significant effect on the radiological gap fill area (standardized mean difference, 0.48 in favor of control; 95%CI, -?1.49 to 0.52; I2?=?0%), the histological gap fill length (standardized mean difference, 0.76 in favor of control; 95%CI, -?1.78 to 0.27; I2?=?0%), or the bone density increase (standardized mean difference, 0.43 in favor of LIPUS; 95%CI, -?0.02 to 0.88; I2?=?0%). CONCLUSIONS:Among patients undergoing distraction osteogenesis, neither the treatment time nor the risk of complications could be reduced by LIPUS therapy. The currently available evidence is insufficient to support the routine use of this intervention in clinical practice. TRIAL REGISTRATION:CRD 42017073596.

Dataset Information

The effects of low-intensity pulsed ultrasound on fresh fracture: A meta-analysis.

Background

Methods

Results

Conclusions

Publications

The effects of low-intensity pulsed ultrasound on fresh fracture: A meta-analysis.

Similar Datasets

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