Artikel
Low intensity pulsed ultrasound in the treatment of non-unions in long bones: Evaluation of cytokine expression course as a tool for objectifying non-union therapy
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Autoren
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Timur Yildirim
- Heidelberg Trauma Research Group, Trauma and Reconstructive Surgery, University Hospital, Heidelberg, Germany
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Christopher Child
- Heidelberg Trauma Research Group, Trauma and Reconstructive Surgery, University Hospital, Heidelberg, Germany
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Wolfgang Danner
- BG Trauma Centre, Ludwigshafen, Germany
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Tim Reitzel
- BG Trauma Centre, Ludwigshafen, Germany
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Thomas Bruckner
- Institute of Medical Biometry and Informatics, University, Heidelberg, Germany
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Elisabeth Biehl
- Heidelberg Trauma Research Group, Trauma and Reconstructive Surgery, University Hospital, Heidelberg, Germany
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Bahram Biglari
- BG Trauma Centre, Ludwigshafen, Germany
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Arash Moghaddam
- Zentrum für Orthopädie, Unfallchirurgie und Paraplegiologie, Trauma and Reconstructive Surgery, Heidelberg Trauma Research Group, Heidelberg, Germany
| Veröffentlicht: | 5. Oktober 2015 |
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Gliederung
Text
Objectives: Non-union is one of the most common complications in bone healing. After several clinical studies, the effect of low intensity pulsed ultrasound (LIPUS) in the treatment of non-unions remains unclear due to the difficulties in evaluating the benefits. In former studies the analysis of serum cytokine expression patterns over time has proven to be an objective method to show the bone healing process and evaluate non-union therapies.
This study contributes to the understanding of LIPUS as a treatment option for patients with non-unions based on the analysis of serum cytokine expression.
Methods: Venous blood samples from 23 patients were taken before the start of LIPUS therapy, at the end of week 1 and 2 and after 1, 2, and 3 months. Patients attended clinical and radiological follow-up examinations at the same intervals. After treating all patients according to the LIPUS therapy protocol, we divided them into two groups: G1 consisted of patients with healing of the fracture site, and G2 included patients with failed non-union therapy. We measured transforming growth factor ß-1 (TGFß-1), platelet-derived growth factor (PDGF), and basic fibroblastic growth factor (bFGF) at all time-points.
Results and Conclusion: The TGF- ß1 serum concentration increased from the pre-treatment value to the time-point of one week within the non-union group. Disregarding this exception, no significant alteration or difference between the groups in measured cytokines during LIPUS therapy could be detected.
Our findings lead to the assumption that LIPUS does have a minimal effect on cytokine expression course but does not provide a sufficient increase in cytokines relevant to bone healing in patients with non-unions.
