You’ve probably heard of PROs using a ‘Bone Stim’. They’re not available to everyone, but I was lucky enough to have a family friend that had a pesky foot bone that wouldn’t heal. Without even asking, they were nice enough to bring it over to my house. Since my incision (and bone) were covered up for the first week, I had plenty of time to do some research before trying it out.
There are two main types of bone stimulators, those that use electrical current, and those that use ultrasound. I received an EXOGEN 4000+, which from what I understand is the only ultrasound device available in the US. I didn’t look into any information comparing the types of stimulators, since I didn’t have much choice in what I would use.
Here in the US, EXOGEN is on approved for very specific uses:
The EXOGEN◊ 4000+, or any other EXOGEN◊ Bone Healing System, is indicated for the non-invasive treatment of established nonunions† excluding skull and vertebra. In addition, they are indicated for accelerating the time to a healed fracture for fresh, closed, posteriorly displaced distal radius fractures and fresh, closed or Grade I open tibial diaphysis fractures in skeletally mature individuals when these fractures are orthopaedically managed by closed reduction and cast immobilization.
In non-doctor speak, this means they’re only FDA approved for non-healing fractures, and specific fresh fractures of the arm and leg, only when casted and not surgically fixed.
The biggest problem related to FDA approved use is insurance coverage. Your insurance is unlikely to cover non-FDA approved use of a medical device, which is why many people borrow a bone stim from a friend (or even buy one on eBay). I understand the cost of EXOGEN to insurance is about $4000, and most patients pay 10%. The going rate on eBay is $250-350 depending on usage. The battery is not replaceable and is guaranteed for only 150 uses (mine is at 165 and still going).
In the UK, the device is approved for many more uses: (emphasis mine)
EXOGEN Ultrasound Bone Healing System is indicated for the non-invasive treatment of osseous defects (excluding vertebra and skull) that includes: Treatment of delayed union and non-unions · Accelerating the time to heal of fresh fractures · Treatment of stress fractures · Accelerating repair following osteotomy · Accelerating repair in bone transport procedures · Accelerating repair in distraction osteogenesis procedures · Treatment of joint fusion.
Also listed in the UK Patient FAQ:
Yes, studies have shown that it can stimulate healing in the presence of metal implants and this means EXOGEN can be used even if your fracture has been stabilised by surgery.
After some quick searching I also found that while my stimulator came with an elastic strap to wrap around an arm, leg or foot, that a ‘bean bag strap’ was available for a clavicle. I simply put a bag of protein shake powder over the strap to hold the transducer in place, mimicking the bean bag. The device runs for 20 minutes and I don’t feel anything when it is running.
My surgeon said that the risk is very low (There are no contraindications listed for the device) and the potential benefit is high, so if I had a stimulator available I should use it. I’m not certain it will help but the only downside is relaxing for 20 minutes on the couch while it works its magic.