The effects of LIPUS on soft-tissue healing: a review of literature.

INTRODUCTION Ultrasound is widely used for imaging purposes and as an adjunct to physiotherapy. Low-intensity pulsed ultrasound (LIPUS), having removed the thermal component found at higher intensities, is used to improve bone healing. However, its potential role in soft-tissue healing is still under investigation. MATERIAL AND METHODS We searched on Medline using the keywords: low-intensity pulsed ultrasound, LIPUS and LIPUS and soft-tissue healing. Thirty-two suitable articles were identified. RESULTS Research, mainly pre-clinical, so far has shown encouraging result, with LIPUS able to promote healing in various soft tissues such as cartilage, inter-vertebral disc, etc. The effect on the bone-tendon junction, however, is primarily on bone. The role of LIPUS in treating tendinopathies is questionable. Adequately powered human studies with standardisation of intensities and dosages of LIPUS for each target tissue are needed.

[1]  R. Spencer,et al.  The influence of pulsed low-intensity ultrasound on matrix production of chondrocytes at different stages of differentiation: an explant study. , 2002, Ultrasound in medicine & biology.

[2]  F. Duck,et al.  A review of therapeutic ultrasound: biophysical effects. , 2001, Physical therapy.

[3]  Jennifer S Wayne,et al.  The Effects of Low-Intensity Ultrasound on Medial Collateral Ligament Healing in the Rabbit Model , 2005, The American journal of sports medicine.

[4]  Sadahiro Iwabuchi,et al.  Low‐intensity pulsed ultrasound stimulation enhances TIMP‐1 in nucleus pulposus cells and MCP‐1 in macrophages in the rat , 2008, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[5]  M. Saito,et al.  Intensity-related differences in collagen post-translational modification in MC3T3-E1 osteoblasts after exposure to low- and high-intensity pulsed ultrasound. , 2004, Bone.

[6]  Byung Hyune Choi,et al.  Low-intensity ultrasound stimulates the viability and matrix gene expression of human articular chondrocytes in alginate bead culture. , 2006, Journal of biomedical materials research. Part A.

[7]  E. Itoi,et al.  Congenital pseudoarthrosis of the tibia treated with low-intensity pulsed ultrasound stimulation (LIPUS). , 2003, Ultrasound in medicine & biology.

[8]  W. Mutschler,et al.  Differential expression of heat shock protein 70 in well healing and chronic human wound tissue. , 1995, Biochemical and biophysical research communications.

[9]  Stuart J. Warden,et al.  Low-Intensity Pulsed Ultrasound Accelerates and a Nonsteroidal Anti-inflammatory Drug Delays Knee Ligament Healing , 2006, The American journal of sports medicine.

[10]  Koichi Masuda,et al.  Exposure to Pulsed Low Intensity Ultrasound Stimulates Extracellular Matrix Metabolism of Bovine Intervertebral Disc Cells Cultured in Alginate Beads , 2005, Spine.

[11]  Sadahiro Iwabuchi,et al.  In vitro evaluation of low-intensity pulsed ultrasound in herniated disc resorption. , 2005, Biomaterials.

[12]  Jinshun Zhao,et al.  Molecular Mechanisms of Low Intensity Pulsed Ultrasound in Human Skin Fibroblasts* , 2004, Journal of Biological Chemistry.

[13]  B. Starcher,et al.  The effect of ultrasound on collagen synthesis and fibroblast proliferation in vitro. , 1995, Medicine and science in sports and exercise.

[14]  D. Hackam,et al.  Translating animal research into clinical benefit , 2007, BMJ : British Medical Journal.

[15]  Yan Yu,et al.  Effects of low-intensity pulsed ultrasound on tendon-bone healing in an intra-articular sheep knee model. , 2007, Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association.

[16]  Jenneke Klein-Nulend,et al.  Low-intensity pulsed ultrasound increases bone volume, osteoid thickness and mineral apposition rate in the area of fracture healing in patients with a delayed union of the osteotomized fibula. , 2008, Bone.

[17]  K. Kawasaki,et al.  Effects of low-intensity pulsed ultrasound on proliferation and chondroitin sulfate synthesis of cultured chondrocytes embedded in Atelocollagen gel. , 2002, Journal of biomedical materials research.

[18]  Ling Qin,et al.  Low intensity pulsed ultrasound increases the matrix hardness of the healing tissues at bone-tendon insertion-a partial patellectomy model in rabbits. , 2006, Clinical biomechanics.

[19]  Diane Dalecki,et al.  Mechanical bioeffects of ultrasound. , 2004, Annual review of biomedical engineering.

[20]  Wen-zhi Chen,et al.  Effects of low-intensity pulsed ultrasound in repairing injured articular cartilage. , 2005, Chinese journal of traumatology = Zhonghua chuang shang za zhi.

[21]  Ling Qin,et al.  Low-intensity pulsed ultrasound accelerates osteogenesis at bone-tendon healing junction. , 2006, Ultrasound in medicine & biology.

[22]  S. Iwabuchi,et al.  Low-intensity pulsed ultrasound accelerates periodontal wound healing after flap surgery. , 2008, Journal of periodontal research.

[23]  Georg N Duda,et al.  Does low-intensity pulsed ultrasound stimulate maturation of tissue-engineered cartilage? , 2004, Journal of biomedical materials research. Part B, Applied biomaterials.

[24]  K. Otsuka,et al.  Low-intensity pulsed ultrasound stimulates osteogenic differentiation in ROS 17/2.8 cells. , 2007, Life sciences.

[25]  Pentti Rokkanen,et al.  The effects of low-intensity pulsed ultrasound on bioabsorbable self-reinforced poly L-lactide screws. , 2002, Biomaterials.

[26]  Naoto Suzuki,et al.  Effects of low-intensity pulsed ultrasound on the differentiation of C2C12 cells. , 2006, Life sciences.

[27]  C. Rubin,et al.  Strain Gradients Correlate with Sites of Periosteal Bone Formation , 1997, Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research.

[28]  C. Speed,et al.  Therapeutic ultrasound in soft tissue lesions. , 2001, Rheumatology.

[29]  D. Subar,et al.  Timing of operative intervention in the management of acutely fractured ankles and the cost implications. , 2001, Injury.

[30]  R. Spencer,et al.  The effects of pulsed low-intensity ultrasound on chondrocyte viability, proliferation, gene expression and matrix production. , 2003, Ultrasound in medicine & biology.

[31]  J. Ong,et al.  Ultrasound effect on osteoblast precursor cells in trabecular calcium phosphate scaffolds. , 2007, Biomaterials.

[32]  Jiliang Li,et al.  Low‐intensity pulsed ultrasound and nonsteroidal anti‐inflammatory drugs have opposing effects during stress fracture repair , 2007, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[33]  Ling Qin,et al.  Low-intensity pulsed ultrasound accelerated bone-tendon junction healing through regulation of vascular endothelial growth factor expression and cartilage formation. , 2008, Ultrasound in medicine & biology.

[34]  Sadahiro Iwabuchi,et al.  Low-intensity pulsed ultrasound stimulates cell proliferation and proteoglycan production in rabbit intervertebral disc cells cultured in alginate. , 2006, Biomaterials.

[35]  A. Eisen,et al.  Human skin fibroblast collagenase. Assessment of activation energy and deuterium isotope effect with collagenous substrates. , 1981, The Journal of biological chemistry.

[36]  Hiromu Ito,et al.  Transforming growth factor-β1 mediates the effects of low-intensity pulsed ultrasound in chondrocytes , 2005 .

[37]  S. Iwabuchi,et al.  Synergistic effect of low‐intensity pulsed ultrasound on growth factor stimulation of nucleus pulposus cells , 2007, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[38]  Cheng-Chang Lu,et al.  Effects of pulsed low-intensity ultrasound on human child chondrocytes. , 2008, Ultrasound in medicine & biology.

[39]  A. Virdi,et al.  Early gene response to low-intensity pulsed ultrasound in rat osteoblastic cells. , 2005, Ultrasound in medicine & biology.

[40]  K. Bennell,et al.  Low-intensity pulsed ultrasound for chronic patellar tendinopathy: a randomized, double-blind, placebo-controlled trial. , 2007, Rheumatology.

[41]  Tomoo Kamakura,et al.  Acoustic streaming induced in focused Gaussian beams , 1995 .

[42]  N. Maffulli,et al.  Conservative management for tendinopathy: is there enough scientific evidence? , 2007, Rheumatology.

[43]  C. Enwemeka,et al.  The biomechanical effects of low-intensity ultrasound on healing tendons. , 1990, Ultrasound in medicine & biology.

[44]  J. Heckman,et al.  The economics of treating tibia fractures. The cost of delayed unions. , 1997, Bulletin (Hospital for Joint Diseases (New York, N.Y.)).

[45]  E. S. Doughty,et al.  The Effect of Low-Intensity Pulsed Ultrasound on Autologous Osteochondral Plugs in a Canine Model , 2008, The American journal of sports medicine.

[46]  G. Du,et al.  Temperature elevation in tissues generated by finite-amplitude tone bursts of ultrasound , 1990 .

[47]  Stuart J Warden,et al.  A New Direction for Ultrasound Therapy in Sports Medicine , 2003, Sports medicine.

[48]  Shinichi Yoshiya,et al.  Low‐Intensity Pulsed Ultrasound Enhances Early Healing of Medial Collateral Ligament Injuries in Rats , 2002, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[49]  Sadahiro Iwabuchi,et al.  Low‐intensity pulsed ultrasound (LIPUS) induces RANKL, MCP‐1, and MIP‐1β expression in osteoblasts through the angiotensin II type 1 receptor , 2007 .

[50]  S D Cook,et al.  Improved Cartilage Repair After Treatment With Low-Intensity Pulsed Ultrasound , 2001, Clinical orthopaedics and related research.

[51]  J. Wasserfallen,et al.  Direct and indirect costs in the conservative management of undisplaced scaphoid fractures , 2003, European Journal of Orthopaedic Surgery & Traumatology.

[52]  M. Sherebrin,et al.  The Effects of Ultrasound Treatment on Flexor Tendon Healing in the Chicken Limb , 1995, Journal of hand surgery.

[53]  J F Greenleaf,et al.  Low‐intensity ultrasound stimulates proteoglycan synthesis in rat chondrocytes by increasing aggrecan gene expression , 1999, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.