目的:骨恢复通常取决于生物体的年龄或代谢紊乱如骨质疏松症的患病率,其特征在于骨强度和骨矿物质密度(BMD)降低的代谢状况。因此,低强度脉冲超声(LIPUS),一种非侵入性的成骨刺激方法,提出了有希望的结果。然而,动物研究设计的异质性是一个典型特征。因此,我们进行了系统评价,目的是使用大鼠模型评价LIPUS修复实验性骨缺损的有效性.我们检查了面积和体积的BMD,以确定要应用的LIPUS剂量,并评估了先前研究报告的准确性。
方法:虚拟健康图书馆区域门户,PubMed,Embase,EBSCOhost,对Scopus和CAPES进行了动物研究,这些动物研究比较了基于LIPUS的骨折治疗与使用大鼠模型的假治疗或无治疗,并报告了BMD作为结果。实验动物实验系统审查中心(SYRCLE)提供的工具以及荟萃分析和实验研究动物数据审查(CAMARADES)清单的协作方法用于评估此类研究的偏倚和质量。
结果:在所审查的六项研究中,最常用的LIPUS剂量的超声频率为1.0MHz,0.1kHz的重复频率和2000μs的脉冲持续时间。对于骨恢复,30mW/cm2的强度(ISATA)是最优选的。然而,由于结果不一致,因此BMD不能完全无可辩驳地评价LIPUS在骨恢复中的有效性.实验方法的差异,在选定的研究中,低质量的分类和高风险的偏倚,然而,没有验证荟萃分析的进行。
结论:根据BMD结果,在大鼠模型中,没有足够的证据推荐使用LIPUS进行骨恢复.因此,本系统综述表明,必须提高此类报告的准确性,以提高其科学质量,从而促进LIPUS应用从临床前研究向临床应用的过渡.
Bone recovery typically depends on the age of organisms or the prevalence of metabolic disorders such as osteoporosis, which is a metabolic condition characterized by decreased bone strength and bone mineral density (BMD). Therefore, low-intensity pulsed ultrasound (LIPUS), a non-invasive method for osteogenic stimulation, presents promising results. However, heterogeneity in animal study designs is a typical characteristic. Hence, we conducted a systematic
review to evaluate the effectiveness of LIPUS in the recovery of experimental bone defects using rat models. We examined the areal and volumetric BMD to identify LIPUS doses to be applied and evaluated the accuracy reported by previous studies.
The Virtual Health Library regional portal, PubMed, Embase, EBSCOhost, Scopus and CAPES were reviewed for animal studies that compared fracture treatments based on LIPUS with sham or no treatments using rat models and reported BMD as an outcome. The tool provided by the Systematic
Review Centre for Laboratory Animal Experimentation (SYRCLE) and the Collaborative Approach to Meta-Analysis and
Review of Animal Data from Experimental Studies (CAMARADES) checklist were used to assess the bias and quality of such studies.
Of the six studies reviewed, the most frequently used LIPUS dose had an ultrasonic frequency of 1.0 MHz, repetition rate of 0.1 kHz and pulse duration of 2000 μs. An intensity (ISATA) of 30 mW/cm2 was the most preferred for bone recovery. However, the BMD could not solely irrefutably evaluate the effectiveness of LIPUS in bone recovery as the results were discordant with each other. The discrepancies in experimental methodologies, low-quality classifications and high risk of bias in the selected studies, however, did not validate the undertaking of a meta-analysis.
On the basis of the BMD results, no sufficient evidence was found to recommend the use of LIPUS for bone recovery in rat models. Thus, this systematic
review indicates that the accuracy of such reports must be improved to improve their scientific quality to facilitate a transition of LIPUS applications from pre-clinical research to clinic use.