Bone stimulators are a therapy that may help with bone healing in certain situations. However, the debate is still out on their effectiveness.
Devices such as bone stimulators are often used for fractures that have failed to heal on their own. These types of fractures are called “nonunions.”
They stimulate the process of osteogenesis, or bone growth.
Keep reading to learn more about bone stimulators, how they work, and what the research says about their effectiveness.
Bone stimulators, also known as bone growth stimulators, are devices that provide energy to bones, which is thought to help with the healing process.
The type of energy used in bone stimulators varies.
- ultrasound: low intensity pulsed ultrasound (LIPUS)
- electromagnetic: pulsed electromagnetic fields (PEMF)
- electric: direct current (DC), capacitive coupling (CC)
Bone stimulators may be internal (implanted under the skin) or external (worn over the skin).
While it’s not completely understood how these devices may help with the healing process, it’s thought that the energy waves from the device create a mechanical load on the bone that triggers the bone to start regenerating.
If you and your doctor decide on this nonsurgical treatment method, the bone stimulator will be placed on your skin close to the nonunion. You may be instructed to do this for 20 minutes to several hours daily.
Bone stimulators are often used to treat nonunions, which are broken bones that fail to heal. This can happen when there’s a lack of stability, blood flow, or both. Infections, particularly after surgery, are also causes of nonunions.
A bone stimulator delivers energy to the nonunion site to stimulate healing.
They may also be used for:
- delayed unions (slow-healing fractures)
- fractures
- spinal fusion surgery
- avascular necrosis/osteonecrosis
The effectiveness of bone stimulators for bone fracture healing remains unclear. Researchers have had mixed results in determining whether these devices can affect the bone microstructure and help heal fractures.
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More research is needed to determine the effects and potentially increase the strength of electric fields that can reach the bone.
Many bone stimulator devices are approved by the FDA.
However, you’ll want to consider your personal circumstances and note the risks before use.
They should not be used in the following cases:
- where the fracture gap is larger than 50% of the bone’s diameter
- where pseudarthrosis (a false joint) has developed
- when magnetic materials have been used to stabilize the bone
- during pregnancy
- in people with a growth disorder (skeletal immaturity)
- in people with pacemakers or defibrillators (without first consulting a cardiologist)
Other risks noted by the
- ineffective treatment resulting in delay of osteogenesis and the need for surgical interventions
- burns from misuse of the device or electrical malfunction
- skin irritation
- tissue damage from prolonged exposure
Additionally, if your bone stimulator is implanted under your skin, as with any invasive surgery, there is a risk of infection.
You’ll require a prescription to use a bone stimulator, and it’s important to only use it as directed by your doctor.
If a doctor has prescribed bone stimulation to help heal your bone fracture, check with your insurance provider to make sure it’s covered. If you do not have insurance, ask your doctor how much this treatment will cost.
Some scientists do not believe there is enough evidence to support the use of bone stimulators, particularly given their high cost.
However, recent research showed that electrical bone growth stimulation is linked to lower healthcare costs when compared to low intensity pulsed ultrasound stimulation or other non-stimulation treatment options.
In addition to a well-balanced diet, including protein, calcium, vitamins C and D, a doctor may suggest other methods to heal a nonunion, such as a surgical bone graft and/or an internal or external fixation.
Surgical bone graft
If nonsurgical methods, such as bone stimulation, are not working, a bone graft might be necessary. Bone grafts provide fresh bone cells to the nonunion and encourage healing.
This procedure works by providing a scaffold on which a new bone may grow. During the surgery, a piece of bone from a different area of the body (or from a cadaver) is collected and then transplanted to the nonunion site. The rim of the pelvis is most often used for this process.
An internal or external fixation is usually part of a surgical bone graft procedure.
Surgical internal or external fixation
Internal or external fixations may also be used to heal a nonunion.
- Internal fixation involves attaching metal plates and screws to the outside of the bone or placing a nail in the inside canal of the bone to stabilize the nonunion.
- External fixation uses a rigid frame attached to the outside of the injured arm or leg, using wires or pins. The ultimate goal is to reduce instability.
External fixation tends to lack stability and is typically used as a quick, temporary way to stabilize a broken bone right after an injury until internal fixation can take place.
Each person and bone issue is different, so your doctor may discuss a wide range of treatment options with you before you consider bone stimulation.
The cost of bone stimulation devices can also vary, which might impact your decision to choose this form of treatment.
Bone stimulators are an innovative, often nonsurgical option, but researchers agree that more data is needed to determine their effectiveness.