Every year around four in 100 people of all ages have a fracture - and
up to 10% of these experience slow or complicated healing. As such,
fractures have been a target for numerous interventions to aid recovery.
LIPUS was approved for fracture healing by the US Food and Drug
Administration (FDA) in 1994 and is also supported by the UK National
Institute for Health and Care Excellence (NICE).
‘Receiving low intensity pulsed ultrasound (LIPUS) to speed up bone healing after fracture has little or no impact on pain or recovery time.’
Each device costs between US$1300 and $5000 and data suggest it is
commonly used in clinical practice. But some studies have shown that the
potential benefits of LIPUS on bone healing are highly uncertain.
New evidence suggests that receiving low intensity pulsed ultrasound
(LIPUS) to speed up bone healing after fracture has little or no impact
on pain or recovery time, say a panel of international experts in The BMJ
They say LIPUS does not represent an efficient use of health resources and recommend that it should be stopped.
Their advice is part of The BMJ
's 'Rapid Recommendations'
initiative - to produce rapid and trustworthy guidance based on new
evidence to help doctors make better decisions with their patients. Both
the new evidence and the guidance are published by The BMJ
So The BMJ
's guideline panel - made up of bone surgeons,
physiotherapists, clinicians and patients with experience of fractures -
carried out a detailed analysis of the latest evidence.
They judged, with moderate to high certainty, that LIPUS has little
or no impact on time to return to work, time to full weight bearing,
pain, the number of subsequent operations, or time to healing assessed
with radiographs (known as radiographic healing).
As such, they unanimously recommend against LIPUS for patients with
any bone fractures or osteotomy (the surgical cutting of a bone to allow
"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," they write.
It is unlikely that new trials will alter the evidence, they add.
And they suggest that future research "should focus on other
interventions that have a greater probability to speed up healing."