Effect of therapeutic ultrasound on bone healing and blood bone markers in dogs with experimental tibial osteotomies

Abstract

Experimental tibial osteotomy was performed in 24 dogs, fixed by either intramedullary (IMO; n = 12) or plate and screw osteosynthesis (PLO; n = 12). Six dogs with IMO and another six with PLO were subjected to daily therapeutic ultrasound therapy at the site of osteotomy for 10 days, starting from the first post-operative day. The other dogs served as controls. Radiological studies were performed immediately after surgery, by week 2 and months 1, 2 and 3. Blood markers of bone formation (bone alkaline phosphatase and osteocalcin) and bone resorption (tartrate-resistant acid phosphatase and C-terminal telopeptide of collagen type I) were assayed before surgery, by post-operative weeks 1 and 2 and months 1, 2 and 3. Therapeutic ultrasound had a beneficial effect on bone formation, bone union and bone resorption. Blood bone alkaline phosphatase exhibited a very high activity as early as weeks 1 and 2, statistically significant compared to controls. Osteocalcin levels were also significantly higher in periods of bone callus mineralization (month 1). From bone resorption markers, only acid phosphatase was increased in the IMO group treated with ultrasound, while C-terminal telopeptide concentrations did not change over the experimental period. It could be concluded that therapeutic ultrasound could be used as a physical adjunct to assist and stimulate early post-operative healing after osteosynthesis of long bones in dogs.