Review the evidence of low intensity pulsed ultrasound (LIPUS) for fracture non-union treatment and the potential to treat fractures in patients with co-morbidities at risk of fracture non-union. Data was gathered from both animal and human studies of fracture repair to provide an overview of the LIPUS in bone healing applications to provide in-depth evidence to substantiate the use in treatment of non-union fractures and to propose a scientific rational to develop a clinical development programme.Abstract
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Osteoarthritis (OA), is characterised with a loss of cartilage and pain in affected joints. It is this pain which most patients associate with their condition. Intra-articular (IA) hyaluronan (HA) has been shown to reduce the pain associated with OA both in animal models and in clinical trials. There are purified HA available and in recent years hyaluronan hydrogels, where the material has been cross-linked into networks, have become available. One of these cross-linked HA hydrogels is Durolane¯. This study has sought to evaluate the effect of Durolane in an in vivo model of osteoarthritis. Mice (C57BL/6, 12 weeks) were obtained from Jackson Labs and all protocols were approved by Rush IACUC. Joint injury was initiated by TGFb1 injection as described [1]. Mice were given IA injections of 200 ng TGFb1, at days 1 and 3 delivered in a 6 ul volume into the rear right knee joint only. Twenty four hours after the second injection of TGFb1 10 ul of Durolane was injected into the same knee joint. All animals were exercised daily on a treadmill to induce tissue degeneration. Three groups of animals were evaluated: Naïve (n = 4), TGFb1 + saline (n = 5) and TGFb1 + Durolane (n = 5). Running performance was monitored daily and 15 days post injections, gait was assessed quantitatively using the TreadScan gait analysis system (CleverSys).Background
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