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PT001 - The use of low-intensity pulsed ultrasound (LIPUS) therapy in fracture healing - November 2018

The EBPB were asked to look at the evidence for the use of low-intensity pulsed ultrasound (LIPUS) therapy in fracture healing.

During the period when the review took place, the National Institute for Health and Care Excellence (NICE) announced that they were reviewing their guidance, and in July 2018 issued interventional procedures guidance (IPG) on LIPUS. The EBPB Evidence Review was then updated to reflect this IPG.

Following consideration of recent published evidence and IPG issued by NICE, the EBPB advise that:

  1. LIPUS should not be used to promote the healing of fresh fractures at low risk of non-healing.
  2. LIPUS should not be used to promote the healing of fresh fractures at high risk of non-healing unless it is done so within the context of research, preferably through randomised controlled trials (see Appendix A of the Advice Statement).
  3. LIPUS should not be used to promote the healing of delayed-union and non-union fractures unless it is done so with special arrangements for clinical governance, consent and audit or research (see Appendix B of the Advice Statement).

The EBPB also draw attention to a BMJ clinical practice guideline, which recommends against the use of LIPUS for bone fracture healing, and which stated that "Further research is unlikely to alter the evidence".

The EBPB Evidence Review Group have issued an Evidence Review (available as a PDF download)  and the EBPB have issued an Advice Statement (available as a PDF download).

If you become aware of a substantial change in the evidence base or circumstances related to this published advice, This email address is being protected from spambots. You need JavaScript enabled to view it. who will then consider whether a further review is necessary.

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** The December 2018 Advice Statement replaces the November 2018 Advice Statement which had a typographical error in Appendix B (which referred to "fresh fractures" in the first sentence rather than "delayed-union and non-union fractures")

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