Low-intensity transosseous ultrasound accelerates osteotomy healing in a sheep fracture model
Low-intensity transosseous ultrasound accelerates osteotomy healing in a sheep fracture model
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DOI：
10.2106/00004623-200410000-00021
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发表时间：
2004-10-01
影响因子：
5.3
通讯作者：
Malizos, KN
中科院分区：
文献类型：
--
作者：
Hantes, ME;Mavrodontidis, AN;Malizos, KN
背景：低强度经皮超声可以加速和增强骨折愈合过程。本研究的目的是在动物模型中探讨经骨应用低强度超声对骨折愈合的影响。方法：对40只绵羊进行左胫骨中段截骨术。使用外固定器稳定截骨部位。在截骨部位近端1.0 cm处将一根细不锈钢针插入骨中。超声通过该销的自由端传输，具有PZT-4D换能器。在20只动物中，接受治疗的肢体每天接受200 μ sec的1 MHz正弦波脉冲串，以1 kHz重复，平均强度为30 mW/cm（2），持续20分钟。另外20只动物接受了相同的手术，但没有接受超声检查（对照组）。在术后75天和120天处死动物。每15天进行一次影像学评价。机械测试和定量计算机断层扫描进行后death.Results：骨折治疗超声愈合显着更快，评估放射学，比对照组（79与103天，p = 0.027）。第75天，平均皮质骨矿物质密度（和标准差）为781 +/- 52 mg/mL，而对照组为543 44 mg/mL（p = 0.014），平均极限强度（通过侧弯试验评估），治疗组肢体为1928 +/- 167 N，对照组为1493 112 N（p = 0.012）。结论：在绵羊截骨模型中，低强度经骨超声可以显著加速骨折愈合过程，增加皮质骨密度，提高骨折愈合后的侧弯强度。临床意义：在骨折部位附近经骨应用低强度超声可以增强骨折骨痂的机械性能，缩短骨折时间。治愈然而，需要进一步的研究来确定该技术的安全性和有效性。
Background: Low-intensity transcutaneous ultrasound can accelerate and augment the fracture-healing process. The aim of this study was to investigate the effect of transosseous application of low-intensity ultrasound on fracture-healing in an animal model.Methods: A midshaft osteotomy of the left tibia was performed in forty sheep. An external fixator was used to stabilize the osteotomy site. A thin stainless-steel pin was inserted into the bone, 1.0 cm proximal to the osteotomy site. Ultrasound was transmitted through the free end of this pin, with a PZT-4D transducer. In twenty animals, the treated limb received a 200-musec burst of 1-MHz sine waves repeated at 1 kHz with an average intensity of 30 mW/cm(2) for twenty minutes daily. Twenty other animals underwent the same surgery but did not receive the ultrasound (controls). Animals were killed at seventy-five and 120 days postoperatively. Radiographic evaluation was performed every fifteen days. Mechanical testing and quantitative computed tomography were performed after death.Results: Fractures treated with ultrasound healed significantly more rapidly, as assessed radiographically, than did the controls (seventy-nine compared with 103 days, p = 0.027). On day 75, the mean cortical bone mineral density (and standard deviation) was 781 +/- 52 mg/mL in the treated limbs compared with 543 44 mg/mL in the control group (p = 0.014), and the average ultimate strength (as assessed with a lateral bending test) was 1928 +/- 167 N in the treated limbs compared with 1493 112 N in the control group (p = 0.012). No significant differences were noted on day 120.Conclusions: This study demonstrated that low-intensity transosseous ultrasound can significantly accelerate the fracture-healing process, increase the cortical bone mineral density, and improve lateral bending strength of the healing fracture in a sheep osteotomy model.Clinical Relevance: Transosseous application of low-intensity ultrasound at close proximity to the fracture site may enhance the mechanical properties of the fracture callus and reduce the time to fracture-healing. However, further investigation is needed to establish the safety and efficacy of the technique.