Low-intensity pulsed ultrasound does not influence bone healing by distraction osteogenesis
| Autor: | Roger M. Atkins, A. H. R. W. Simpson, G. Keenan, S. Nayagam, Nicholas D. Clement, David Marsh |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Bone Regeneration Ultrasonic Therapy medicine.medical_treatment Osteogenesis Distraction Ilizarov Technique Kaplan-Meier Estimate Bone healing Low-intensity pulsed ultrasound Placebo bone osteogenesis law.invention 03 medical and health sciences 0302 clinical medicine Double-Blind Method Randomized controlled trial law medicine Humans Orthopedics and Sports Medicine Postoperative Period Prospective Studies 030212 general & internal medicine Postoperative Care 030222 orthopedics Tibia ultrasound business.industry Ultrasound Hazard ratio Middle Aged healing pulsed Surgery Treatment Outcome Patient Compliance Distraction osteogenesis Female Exogen business Corticotomy |
| Zdroj: | Simpson, H, Keenan, G, Nayagam, D, Atkins, R, Marsh, D & Clement, N D 2017, ' Low-intensity pulsed ultrasound does not influence bone healing by distraction osteogenesis: a multicentre double blind randomised control trial ', Bone and Joint Journal, vol. BJJ-2016-0559.R1 . https://doi.org/10.1302/0301-620X.99B4.BJJ-2016-0559.R1 |
| ISSN: | 2049-4408 2049-4394 |
| DOI: | 10.1302/0301-620x.99b4.bjj-2016-0559.r1 |
| Popis: | Aims The aim of this double-blind prospective randomised controlled trial was to assess whether low intensity pulsed ultrasound (LIPUS) accelerated or enhanced the rate of bone healing in adult patients undergoing distraction osteogenesis. Patients and Methods A total of 62 adult patients undergoing limb lengthening or bone transport by distraction osteogenesis were randomised to treatment with either an active (n = 32) or a placebo (n = 30) ultrasound device. A standardised corticotomy was performed in the proximal tibial metaphysis and a circular Ilizarov frame was used in all patients. The rate of distraction was also standardised. The primary outcome measure was the time to removal of the frame after adjusting for the length of distraction in days/cm for both the per protocol (PP) and the intention-to-treat (ITT) groups. The assessor was blinded to the form of treatment. A secondary outcome was to identify covariates affecting the time to removal of the frame. Results There was no difference in the time to removal of the frame between the PP (difference in favour of the control group was 10.1 days/cm, 95% confidence interval (CI) -3.2 to 23.4, p = 0.054) or ITT (difference 5.0 days/cm, 95% CI -8.2 to 18.21, p = 0.226) groups. The smoking status was the only covariate which increased the time to removal of the frame (hazard ratio 0.47, 95% CI 0.22 to 0.97, p = 0.042). Conclusion LIPUS does not influence the rate of bone healing in patients who undergo distraction osteogenesis. Smoking may influence bone healing. Cite this article: Bone Joint J 2017;99-B:494–502. |
| Databáze: | OpenAIRE |
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