Yusuf H Mirza1, Kar Hao Teoh2, David Golding3, Jenny F Wong4, Yogesh Nathdwarawala3. 1. Hospital- Ysbyty Glan Clwyd, Bodelwyddan, Rhyl, United Kingdom; South Wales Orthopaedic Research Network/WelshBone, Department of Trauma and Orthopaedics, Princess of Wales Hospital, Coity Road, Bridgend, United Kingdom. Electronic address: yusufmirza@me.com. 2. South Wales Orthopaedic Research Network/WelshBone, Department of Trauma and Orthopaedics, Princess of Wales Hospital, Coity Road, Bridgend, United Kingdom; The Princess Alexandra Hospital, Harlow, Essex, United Kingdom. 3. Foot and Ankle Unit, Ysbyty Ystrad Fawr, Ystrad Fawr Way, Ystrad Mynach, Hengoed CF82 7EP, United Kingdom. 4. South Wales Orthopaedic Research Network/WelshBone, Department of Trauma and Orthopaedics, Princess of Wales Hospital, Coity Road, Bridgend, United Kingdom.
Abstract
BACKGROUND: Delayed union and nonunion following foot and ankle arthrodesis is a disabling complication for patients. There are no clinical studies looking at whether there is a role for use of low-intensity pulsed ultrasound (LIPUS) following this. The aim of this study is to investigate the efficacy of LIPUS in this cohort of patients in our centre. METHODS: This was a retrospective observational study reviewing the use of LIPUS in patients who had arthrodesis of a number of different foot and ankle joints diagnosed with delayed or non-union. RESULTS: Over a 5year period, 18 patients (71st MTPJ fusion, 2 subtalar joints, 2 triple fusion, 4 ankle fusions and 3 isolated midfoot joint) with radiologically confirmed delayed union, were treated with a standardised LIPUS therapy. Twelve patients (67%) were treated successfully with full radiological union confirmed. 4 patients required further surgical revision surgery while 2 were treated conservatively. Isolated small foot joints demonstrated a higher incidence of fusion (9/10; 90%) after LIPUS in comparison to larger or multiple joint arthrodesis (3/8; 38%). CONCLUSIONS: There may be a role for the use of LIPUS as a treatment option in delayed union of isolated, small foot joint arthrodesis. However, we would not recommend its use in large or multiple F&A joint arthrodesis. Large multicentre series are required to confirm our findings.
BACKGROUND: Delayed union and nonunion following foot and ankle arthrodesis is a disabling complication for patients. There are no clinical studies looking at whether there is a role for use of low-intensity pulsed ultrasound (LIPUS) following this. The aim of this study is to investigate the efficacy of LIPUS in this cohort of patients in our centre. METHODS: This was a retrospective observational study reviewing the use of LIPUS in patients who had arthrodesis of a number of different foot and ankle joints diagnosed with delayed or non-union. RESULTS: Over a 5year period, 18 patients (71st MTPJ fusion, 2 subtalar joints, 2 triple fusion, 4 ankle fusions and 3 isolated midfoot joint) with radiologically confirmed delayed union, were treated with a standardised LIPUS therapy. Twelve patients (67%) were treated successfully with full radiological union confirmed. 4 patients required further surgical revision surgery while 2 were treated conservatively. Isolated small foot joints demonstrated a higher incidence of fusion (9/10; 90%) after LIPUS in comparison to larger or multiple joint arthrodesis (3/8; 38%). CONCLUSIONS: There may be a role for the use of LIPUS as a treatment option in delayed union of isolated, small foot joint arthrodesis. However, we would not recommend its use in large or multiple F&A joint arthrodesis. Large multicentre series are required to confirm our findings.