China
Africa
Explore chapters and articles related to this topic
Bone Injury, Healing and Grafting
Published in Manoj Ramachandran, Tom Nunn, Basic Orthopaedic Sciences, 2018
Peter Bates, Andrea Yeo, Manoj Ramachandran
There is good evidence that low-intensity pulsed ultrasound (LIPUS) can affect gene expression, stimulate chondroblast and osteoblast activity, enhance blood flow and accelerate or augment fracture healing. Pressure waves from ultrasound may also stimulate differentiating bone lining cells along the edges of a fracture. There is NICE guidance on the use of LIPUS in the management of delayed union and non-union.
Extremity trauma
Published in Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie, Bailey & Love's Short Practice of Surgery, 2018
Professor Sir Norman Williams, Professor P. Ronan O’Connell, Professor Andrew W. McCaskie
Several chemical and mechanical methods have been attempted to enhance fracture healing, including bone marrow injections into the fracture site and other orthobiologics such as bone morphogenic proteins. Mechanical methods include controlled axial micromotion (using an external fixator), electromagnetic stimulation and low intensity pulsed ultrasound. There is good basic scientific evidence to support their theoretical benefit; however, to date there is little clinical evidence for their use in the primary treatment of closed fractures.
Osteoporosis and Exercise in the Older Adult
Published in K. Rao Poduri, Geriatric Rehabilitation, 2017
Roger P. Rossi, Talya K. Fleming, Krishna J. Urs, Sara J. Cuccurullo
Low-intensity pulsed ultrasound (LIPUS) has been used to improve fracture healing, and has been approved for several years by the United States Food and Drug Administration. Some preclinical and clinical evidence indicates that fracture healing can be improved by this technique, which appears to be generally safe. There are several suggested mechanisms of action of LIPUS. Clinical studies generally support its usefulness in accelerating fracture healing (77). Initial research from weekly radiography, histomorphometry, microcomputed tomography, and mechanical testing showed the treatment groups with better healing responses than their control groups. Comparing the normal and the osteoporotic treatment groups, a significantly higher (p = 0.015) callus width (week 4), higher ratio of increment in bone volume to tissue volume ratio value (7.4% more), faster response of endochondral ossification, and a higher stiffness measurement were observed in the osteoporotic treatment group (78). There is ongoing research to better determine the optimal protocol for LIPUS use.
Successful treatment of infectious delayed union after ulnar shortening osteotomy using once-weekly teriparatide with low-intensity pulsed ultrasound
Published in Case Reports in Plastic Surgery and Hand Surgery, 2021
Kiyohito Takamatsu, Takuya Uemura, Ema Onode, Masaru Koshimune
One month after implant removal and debridement, the infection was still under control. However, bony absorption was observed at the osteotomy site on computed tomography (CT) (Figure 2(B)). For the delayed union of the distal ulna, we planned excision of pseudoarthrosis and bone graft after 6 months of normal CRP levels and white blood cell count levels. Low-intensity pulsed ultrasound (LIPUS) was initiated during the waiting period. Additionally, weekly subcutaneous injections of teriparatide (56.5 µg, Teribone; Asahi Kasei Pharma, Tokyo, Japan) were used to accelerate the bone healing and treat the patient’s osteoporosis. After the second surgery of implant removal, the bone mineral density was checked and it was 61% of the young adult mean. In short, LIPUS and teriparatide therapy was started 6 weeks after implant removal and debridement, respectively. LIPUS and teriparatide had been used for 5 months and 12 months, respectively.
The use of low-intensity pulsed ultrasound in hand and wrist nonunions
Published in Journal of Plastic Surgery and Hand Surgery, 2020
Michael H Elvey, Robert Miller, Keng Suan Khor, Evangelia Protopapa, Maxim D Horwitz, Alistair R Hunter
The use of ultrasound waves to stimulate bone formation was first reported in 1950 [1]; however, it was not until the 1980’s that the technology was successfully applied to the treatment of human fractures [2]. Over the next two decades a growing evidence base resulted in the US Food and Drug Administration (FDA) and the UK National Institute for Health and Care Excellence (NICE) approving Low-Intensity Pulsed Ultrasound (LIPUS) as a primary and adjuvant treatment for managing acute fractures [3]. However, despite a growing body of evidence, questions remain over its benefits. A recent meta-analysis in the British Medical Journal concluded that LIPUS did not improve outcomes important to patients and probably had no effect on radiographic bone healing in acute fractures but was unable to provide conclusions on the efficacy in nonunions [4]. In 2013, NICE issued guidelines supporting the use of LIPUS for established nonunions [3]. This guidance was based largely on evidence evaluating long bone nonunions and consequently there is little evidence to guide the use of LIPUS in the hand and wrist [3]. Despite this LIPUS continues to be used for these challenging nonunion cases.
Low intensity pulsed ultrasound promotes the migration of bone marrow- derived mesenchymal stem cells via activating FAK-ERK1/2 signalling pathway
Published in Artificial Cells, Nanomedicine, and Biotechnology, 2019
Junlin Chen, Jingwei Jiang, Wei Wang, Juan Qin, Jinyun Chen, Wenzhi Chen, Yan Wang
As we all known, cell migration, an important part of cell homing, is the movement of cells from source to the region where there is a requirement of response or action [12]. The effects on BMSCs homing will be improved when migration rate is increased. Recently, preconditioning strategies have provided new ideas for promoting homing of endogenous and exogenous mesenchymal stem cells [13]. Low intensity pulsed ultrasound (LIPUS) has been reported to promote the proliferation and differentiation of BMSCs and accelerate the repair of tissues [14–16]. We considered LIPUS can improve the BMSCs migration as same as accelerating the proliferation and differentiation of BMSCs. So, we designed the project to research the LIPUS effects on the BMSCs migration in vitro and in vivo, and the roles of functional genes involved in migration, FAK and ERK1/2 signalling pathways related to cell migration.