Editorial Commentary: Treatment Efficacy Found in Animal Studies May Not Translate to Humans

Efficacy of low-intensity pulsed ultrasonography (LIPUS) has been demonstrated in several mammalian models of injury/repair of tendons, ligaments, and soft tissue-bone junctions. But human studies have not demonstrated benefit from such intervention. In addition to innate healing differences between humans and research animals, another reason for this outcome variance may be that animal investigations of LIPUS have so far focused on healing after acute intervention, whereas randomized clinical trials have only looked at treating chronic tendinopathy in symptomatic patients. On the basis of current animal data, potential clinical benefit of LIPUS is most likely to be demonstrated for addressing acute injuries or postoperative scenarios. Yet, a particularly important anatomic difference between humans and experimental land animals regarding ultrasonography is the presence of subcutaneous adipose in the former versus the lack thereof in the latter, especially in the extremities, because overlying adipose attenuates ultrasound waves directed at underlying injured, repaired, or reconstructed tissues.