Low-intensity pulsed ultrasound
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|Low-intensity pulsed ultrasound|
Low-intensity pulsed ultrasound (LIPUS) is a medical technology, generally using 1.5 MHz frequency pulses, with a pulse width of 200 μs, repeated at 1 kHz, at a spatial average and temporal average intensity of 30 mW/cm2. As of 2009 research for the use of LIPUS to treat soft tissue injuries were in the early stages. As of 2012 it was being studied for dental problems.
Low intensity pulsed ultrasound has been proposed as a therapy to support bone healing after fractures, osteotomies, or delayed healing. A 2017 review, however, found no trustworthy evidence for the use of low intensity pulsed ultrasound for bone healing. An associated guideline issued a strong recommendation against its use in bone healing. Evidence as of 2014 was insufficient to justify its use to prevent non healing of bone fractures. Tentative evidence supports better healing with the use of the system in long bones that have not healed after three months. Some reviews suggested inconclusive evidence of benefit. One industry supported meta-analysis suggested it as a potential alternative to surgery for established nonunions. Most studies suggesting benefit were funded by manufacturers of ultrasound devices.
Starting around the 1950s this technology was being used as a form of physical therapy for ailments such as tendinitis.
- Khanna, A; Nelmes, RT; Gougoulias, N; Maffulli, N; Gray, J (2009). "The effects of LIPUS on soft-tissue healing: a review of literature". British medical bulletin. 89: 169–82. doi:10.1093/bmb/ldn040. PMID 19011263.
- Rego, E. B. (2012). "Current Status of Low Intensity Pulsed Ultrasound for Dental Purposes". The Open Dentistry Journal. 6: 220–5. doi:10.2174/1874210601206010220. PMC . PMID 23341848.
- Schandelmaier, Stefan; Kaushal, Alka; Lytvyn, Lyubov; Heels-Ansdell, Diane; Siemieniuk, Reed A. C.; Agoritsas, Thomas; Guyatt, Gordon H.; Vandvik, Per O.; Couban, Rachel; Mollon, Brent; Busse, Jason W. (22 February 2017). "Low intensity pulsed ultrasound for bone healing: systematic review of randomized controlled trials". BMJ. 356: j656. doi:10.1136/bmj.j656. ISSN 1756-1833.
- Poolman, RW; Agoritsas, T; Siemieniuk, RA; Harris, IA; Schipper, IB; Mollon, B; Smith, M; Albin, A; Nador, S; Sasges, W; Schandelmaier, S; Lytvyn, L; Kuijpers, T; van Beers, LW; Verhofstad, MH; Vandvik, PO (21 February 2017). "Low intensity pulsed ultrasound (LIPUS) for bone healing: a clinical practice guideline". BMJ (Clinical research ed.). 356: j576. doi:10.1136/bmj.j576. PMID 28228381.
- Griffin, XL; Parsons, N; Costa, ML; Metcalfe, D (23 June 2014). "Ultrasound and shockwave therapy for acute fractures in adults". The Cochrane Database of Systematic Reviews (6): CD008579. doi:10.1002/14651858.CD008579.pub3. PMID 24956457.
- Higgins, A; Glover, M; Yang, Y; Bayliss, S; Meads, C; Lord, J (October 2014). "EXOGEN ultrasound bone healing system for long bone fractures with non-union or delayed healing: a NICE medical technology guidance". Applied Health Economics and Health Policy. 12 (5): 477–84. doi:10.1007/s40258-014-0117-6. PMC . PMID 25060830.
- Lou, S.; Lv, H.; Li, Z.; Zhang, L.; Tang, P (1 September 2017). "The effects of low-intensity pulsed ultrasound on fresh fracture: A meta-analysis". Medince (39): e8181. PMID 28953676.
- Leighton, R.; Watson, J.T; Giannoudis, P.; Papakostidis, C.; Harrison, A.; Steen, R.G. (May 2017). "Healing of fracture nonunions treated with low-intensity pulsed ultrasound (LIPUS): A systematic review and meta-analysis". Injury (7): 1339–1347. PMID 28532896.
- Miller, Douglas; Smith, Nadine; Bailey, Michael; Czarnota, Gregory; Hynynen, Kullervo; Makin, Inder (April 2012). "Overview of Therapeutic Ultrasound Applications and Safety Considerations". Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine. 31 (4): 623–634. doi:10.7863/jum.2012.31.4.623. ISSN 0278-4297. PMC . PMID 22441920.
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