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09-32961227 (maksuton).

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A cohort study of 4,190 patients treated with low-intensity pulsed ultrasound (LIPUS): findings in the elderly versus all patients.

BMC Musculoskeletal Disorders,
Robert Zura, Samir Mehta, Gregory J. Della Rocca, John Jones, R. Grant Steen

BACKGROUND:

Patient age is one of many potential risk factors for fracture nonunion. Our hypothesis is that older patients (≥ 60) with fracture risk factors treated with low-intensity pulsed ultrasound (LIPUS) have similar heal rate (HR) to the population as a whole. We evaluate the impact of age in conjunction with other risk factors on HR in LIPUS-treated patients with fresh fracture (≤ 90 days old).

METHODS:

The Exogen Bone Healing System is a LIPUS device approved in 1994 to accelerate healing of fresh fracture. After approval, the FDA required a Post-Market Registry to assess performance. Patient data collected from October 1994 until October 1998 were individually reviewed and validated by a registered nurse. Four distinct data elements were required to report a patient: date fracture occurred; date treatment began; date treatment ended; and a dichotomous outcome of healed v. failed, by clinical and radiological criteria. Data were used to calculate two derived variables; days to treatment (DTT) and days on treatment (DOT). Every validated fresh fracture patient with DTT, DOT, and outcome is reported.

RESULTS:

The validated registry had 5,765 patients with fresh fracture; 73% (N = 4,190) are reported, while 13% of patients were lost to follow-up, 11% withdrew or were non-compliant, and 3% died or are missing outcome. Among treatment-compliant patients, HR was 96.2%. Logistic estimates of the odds ratio for healing are equivalent for patients age 30 to 79 years and all age cohorts had a HR > 94%. Open fracture, current smoking, diabetes, vascular insufficiency, osteoporosis, cancer, rheumatoid arthritis, and prescription NSAIDs all reduced HR, but older patients (≥ 60) had similar HRs to the population as a whole. DTT was significantly shorter for patients who healed (p < 0.0001).

CONCLUSIONS:

Comorbid conditions in conjunction with aging can reduce fracture HR. Patients with fracture who used LIPUS had a 96% HR, whereas the expected HR averages 93%. Time to treatment was significantly shorter among patients who healed (p < 0.0001), suggesting that it is beneficial to begin LIPUS treatment early. Older patients (≥ 60) with fracture risk factors treated with LIPUS exhibit similar heal rates to the population as a whole.

 

Full article available at PubMed.gov.

Low-Intensity Pulsed Ultrasound for Treatment of Fractures and Nonunions - Current Evidence and Insights from Basic Research and Clinical Application

Z Orthop Unfall.,
Randau TM, Kabir K, Gravius S, Wimmer MD, Friedrich MJ, Burger C, Goost H

In Germany, 800,000 fractures are treated per year, and up to 10 % of these patients may suffer subsequently from a delayed union or a nonunion at the fracture site. Surgical treatment of these complications is tedious and associated with high costs. Therefore non-operative treatment is recently receiving more scientific and clinical attention. The adjuvant treatment with ultrasound has been propagated for the past years to enhance fracture healing and bony union, and has been discussed controversially. This review article demonstrates the significance of the low intensity pulsed ultrasound application in fracture treatment, on the basis of basic science results, animal experiments and the results of clinical trials.

Full article available at PubMed.gov.

Low-intensity pulsed ultrasound in the treatment of nonunions.

The Journal of Trauma,
Nolte PA, van der Krans A, Patka P, Janssen IM, Ryaby JP, Albers GH

Tässä tutkimuksessa todettiin, että EXOGEN voi olla hyödyllinen hoidettaessa vaativia, luutumattomia murtumia, jolloin paranemisprosentti oli 86 %.

Lue koko artikkeli osoitteessa PubMed.gov.

Low-intensity pulsed ultrasound: effects on nonunions

Ultrasound in Medicine and Biology,
Gebauer D, Mayr E, Orthner E, Ryaby JP

Tässä tutkimuksessa 67 luutumatonta murtumaa hoidettiin EXOGEN-laitteella. Päivittäisten 20 minuutin hoitojen jälkeen 85 % luutumattomista murtumista parani.

Lue koko artikkeli osoitteessa PubMed.gov.

Improved healing response in delayed unions of the tibia with low-intensity pulsed ultrasound: results of a randomized sham-controlled trial

BMC Musculoskeletal Disorders,
Schofer MD, Block JE, Aigner J, Schmelz A

Tässä Level-1-tason tutkimuksessa 51 potilasta, joiden sääriluun murtuman luutuminen oli pitkittynyt, hoidettiin EXOGEN-laitteella. Luun mineraalitiheys todettiin keskimäärin 1,34 kertaa suuremmaksi kuin potilailla, joita hoidettiin lumelaitteella.

Lataa tai lue  koko artikkeli osoitteessa PubMed.gov.

Acceleration of tibia and distal radius fracture healing in patients who smoke

Clinical Orthopaedics and Related Research,
Cook SD, Ryaby JP, McCabe J, Frey JJ, Heckman JD, Kristiansen TK

Tässä tutkimuksessa havaittiin, että EXOGEN-laitteen käyttö nopeutti todettujen* sääriluiden ja värttinäluiden murtumien paranemista tupakoitsijoilla – sääriluiden murtumat paranivat 41 % nopeammin ja värttinäluiden päiden murtumat 51 % nopeammin.

Lue koko artikkeli osoitteessa PubMed.gov.

Acceleration of tibial fracture-healing by non-invasive, low-intensity pulsed ultrasound

The Journal of Bone and Joint Surgery,
Heckman JD, Ryaby JP, McCabe J, Frey JJ, Kilcoyne RF

Tämä tutkimus havainnollistaa murtumien parantamiseen käytettävän EXOGEN -järjestelmän tehoa. Tuoreiden* murtumien parantumisajan todettiin lyhenevän huomattavasti, kun EXOGEN-laitetta käytettiin 20 minuutin ajan päivittäin. EXOGEN-laitetta käyttävien ryhmässä 94 % murtumista parantui 150 päivän aikana.

Lue koko artikkeli osoitteessa PubMed.gov.

Accelerated healing of distal radial fractures with the use of specific, low-intensity ultrasound. A multicenter, prospective, randomized, double-blind, placebo-controlled study

The Journal of Bone and Joint Surgery,
Kristiansen TK, Ryaby JP, McCabe J, Frey JJ, Roe LR

Tässä tutkimuksessa 60 potilasta, jolla oli tuore värttinäluun murtuma, sai hoitoa joko EXOGEN-laitteella tai lumelaitteella kymmenen viikon ajan. EXOGEN-laitteen käyttäjien murtumat luutuivat huomattavasti nopeammin, mikä oli havaittavissa kaikissa paranemisen vaiheissa.

Lue koko artikkeli osoitteessa PubMed.gov.

Indications and results for the EXOGEN ultrasound system in the management of non-union: a 59-case pilot study.

Orthopaedics, Traumatology, Surgery & Research (OTSR),
Roussignol X, Currey C, Duparc F, Dujardin F.

Tämä pilottisarja pyrki arvioimaan EXOGENin käyttöä reisi- ja sääriluiden luutumattomissa murtumissa. Luiden paranemisprosentti oli 88 %, mikä on korkeampi kuin perinteisellä kirurgialla hoidettujen murtumien paranemisprosentti, ja hoidon kustannukset olivat vähintään 60 % pienemmät. Nämä tiedot puhuvat laitteen ensilinjakäytön puolesta alle 10 mm:n luutumattomien murtumien hoidossa, jos luuosien yhdistäminen on onnistunut luotettavasti.

Lue tiivistelmä osoitteessa PubMed.gov.

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