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Regenerate bone stimulation following limb lengthening: a meta-analysis
Julio J Jauregui1, Anthony V Ventimiglia2, Preston W Grieco2
1Department of Orthopaedics, University of Maryland Medical Center, 110 S. Paca Street, 6th Floor, Suite 300, Baltimore, Maryland, 21201, USA.
Low intensity pulsed ultrasound (LIPUS) and pulsed electromagnetic fields (PEMF) can accelerate bone healing during limb lengthening. These non-pharmacological treatments reduced the healing time in patients undergoing limb lengthening procedures.
Area of Science:
- Orthopedics
- Regenerative Medicine
- Biomaterials
Background:
- Limb lengthening is a procedure to correct leg length discrepancies or short stature.
- External fixation is commonly used, but prolonged consolidation time is a drawback.
- Non-union and delayed-union are potential complications of limb lengthening.
Purpose of the Study:
- To systematically evaluate the effects of low intensity pulsed ultrasound (LIPUS) and pulsed electromagnetic fields (PEMF) on regenerate bone growth.
- To assess whether LIPUS and PEMF impact treatment duration in limb lengthening.
Main Methods:
- A literature search was conducted using Medline, Embase, and Ovid databases.
- Studies on LIPUS or PEMF application post-limb lengthening were included.
- Forest plots were used to compare bone healing index with and without bone stimulation.
Main Results:
- Seven studies involving 153 patients were analyzed.
- Bone stimulation (LIPUS/PEMF) resulted in a faster mean healing index (11.7 days/cm faster).
- The mean healing index was 33.7 days/cm with stimulation versus 45.4 days/cm without.
Conclusions:
- LIPUS and PEMF can decrease bone healing time in limb lengthening patients.
- These non-pharmacological modalities show potential for stimulating regenerate bone growth.
- Complications, potentially related to the procedure or stimulation, require attention.
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