Over the years, the technology for bone healing has advanced dramatically, and electrical stimulation has emerged as one of the newer alternative therapies for bone healing. One such alternative treatment is that of bone stimulation. Bone stimulators are devices that are commonly used for treating fractures that have been unable to heal by themselves. However, there is a lot of debate on whether bone simulators are actually effective in treating these non-healing fractures. Let us take a closer look at what are bone stimulators and do they work in healing bones or not.
What are Bone Stimulators and How Do They Work?
Bone stimulators are used for treating fractures that have failed to heal by themselves.(1) These types of non-healing fractures are known as ‘non-unions.’ However, the jury is still out on whether bone stimulators actually work in treating these non-union fractures or not.
Bone stimulators help heal non-healing fractures by acting as a constant-current source. A bone stimulator is made up of one or more cathodes and one anode. The device works by generating an electric current, which is supposed to stimulate bone growth around the cathodes/cathode. Basically, the bone stimulator works by delivering ultrasonic or pulsed electromagnetic waves to the site of the fracture to kick start the healing process.
The exact manner in which a bone stimulator stimulates bone growth is not entirely understood, but numerous experiments have shown that bone stimulators help with the overall healing process. It is also believed that these devices are especially useful in healing non-unions, which are fractures that do not heal on their own.
Non-unions may occur because of a lack of blood flow, lack of stability, or both in the particular area where the fracture has occurred. Infections can also be a cause of non-unions, especially after a surgical procedure.
If your doctor decides on using this non-surgical method of treating a non-union fracture, then the bone stimulator will be placed on your skin, close to where the non-healing fracture is. The stimulator will be placed for 20 minutes or to several hours every day.
At the same time, you will be recommended to increase your daily intake of vitamin C, vitamin D, and calcium as the treatment process continues. This is believed to encourage the bones to start producing new and healthy cells to help boost the healing process.
Do Bone Stimulators Actually Work?
The effectiveness of bone stimulators in healing bone fractures is under debate. Research carried out by the Center for Bone Healing and Research in Canada(1), found mixed results in determining whether bone stimulators actually have any effect on the microstructure of bones and help in healing fractures.
In 2016, the McMaster University in Canada carried out a review of several studies that found that patients who were treated with electrical stimulation ended up experiencing less pain and also had lower rates of developing persistent non-unions.(2)
However, earlier in 2008, a review of certain randomized controlled trials had found that only 1 out of 4 adults experienced any reduction in pain and also discovered that the electrical stimulation had no dramatic effect on the healing of the bone.(3)
Since there are no side effects to electrical stimulation, researchers firmly believe that more in-depth research is required on the use and effectiveness of devices that use electrical stimulation (such as bone stimulators) for healing bone fractures.
Cost of Bone Stimulation
The cost of bone stimulators varies from place to place. In 2018, a study was done on patients who underwent bone stimulation after a surgical procedure ended up incurring quite a high cost on average.(4)
However, newer research has indicated that the use of electrical bone growth stimulation is associated with a lower healthcare cost when you compare it to low-intensity pulsed ultrasound stimulation or any other non-stimulation treatment techniques for bone healing.(5)
On average, though, depending on the extent of the bone fracture and healing required, the cost of bone stimulation can range from anywhere between $5,000 to $15,000.(6)
Safety of Bone Stimulators
Bone stimulators are considered to be quite safe, and to date, there have been no known adverse side effects in people from using bone growth stimulators.(7) However, according to research published in the journal Podiatry. Today(8), bone stimulators should not be used in the following circumstances:
- In pregnant women
- In people with any type of growth disorder, such as skeletal immaturity
- In people who have pacemakers or defibrillators – it can be performed after getting a go-ahead from the cardiologist
- In cases where the fracture gap is greater than 50 percent of the bone’s diameter
- In instances where pseudarthrosis (a false joint) has developed
- In instances where magnetic materials have already been used for stabilizing the bone
Each type of nonunion is different. This means that your doctor will explore many types of treatment options with you before finalizing one treatment method. Bone stimulation is also an option that will be considered. The cost of bone stimulation varies depending on many factors, including how big the fracture is. The cost of bone stimulation may have an impact on your decision on whether to go ahead with this treatment plan or not. Keep in mind that many insurance providers do not cover the cost of bone stimulation.
There is no doubt that bone stimulators are innovative, a non-surgical technique, and a technique without side effects that can help heal fractures. However, researchers agree that more research is still needed to determine how effective bone stimulator devices can be in healing fractures.
- Victoria, G., Petrisor, B., Drew, B. and Dick, D., 2009. Bone stimulation for fracture healing: What’s all the fuss?. Indian journal of orthopaedics, 43(2), p.117.
- Aleem, I.S., Aleem, I., Evaniew, N., Busse, J.W., Yaszemski, M., Agarwal, A., Einhorn, T. and Bhandari, M., 2016. Efficacy of electrical stimulators for bone healing: a meta-analysis of randomized sham-controlled trials. Scientific reports, 6, p.31724.
- Mollon, B., da Silva, V., Busse, J.W., Einhorn, T.A. and Bhandari, M., 2008. Electrical stimulation for long-bone fracture-healing: a meta-analysis of randomized controlled trials. JBJS, 90(11), pp.2322-2330.
- D’Oro, A., Buser, Z., Brodke, D.S., Park, J.B., Yoon, S.T., Youssef, J.A., Meisel, H.J., Radcliff, K.E., Hsieh, P. and Wang, J.C., 2018. Trends and Costs of External Electrical Bone Stimulators and Grafting Materials in Anterior Lumbar Interbody Fusion. Asian spine journal, 12(6), p.973.
- Longdom.org. (2019). [online] Available at: https://www.longdom.org/open-access/cost-savings-associated-with-the-use-of-electrical-bone-growth-stimulation-to-treat-diabetic-patients-in-the-us-with-fracture-nonunion-2155-6156.1000262.pdf [Accessed 29 Dec. 2019].
- Button, M.L., Sprague, S., Gharsaa, O., LaTouche, S. and Bhandari, M., 2009. Economic evaluation of bone stimulation modalities: A systematic review of the literature. Indian journal of orthopaedics, 43(2), p.168.
- Hca.wa.gov. (2019). [online] Available at: https://www.hca.wa.gov/assets/program/bgs_final_report_073109_updated.pdf [Accessed 29 Dec. 2019].
- Podiatry Today. (2019). Does The Evidence Support The Use Of Bone Growth Stimulators After Common Podiatric Surgery Procedures?. [online] Available at: https://www.podiatrytoday.com/blogged/does-evidence-support-use-bone-growth-stimulators-after-common-podiatric-surgery-procedures [Accessed 29 Dec. 2019].