Ultrasound therapy and metal implant

[gcoe]

Hi thisoldPT

You are quite right there are are studies to support the damaging effects of insonating over metal implants. However I think you are being a bit unrealistic if you expect there to be such studies. Apart from the risk studies for cervical manipulation as far as I know PT doesn't have such studies. It would be hard to do such studies as adverse events would be few and far between so you would need mammoth sample sizes. Big issues to get through an ethics committee and anyway would there be enough PTs using US these days to warrant such a study?

Animal studies - don't know of any - but they would only pick up large tissue damage.

So...opinion is what you are left with and that opinion should be based on biomedical science.

In my opinion I would interpret the use of US with metal implants as a precaution and a potential hazard not an absolute contraindication. Kitchen & Dyson both mention precautions with implants along with other things like bony interfaces. The issue is the interface of soft tissue to the hard surfaces where we know we get energy problems with changes in behaviour of the the US Waves. Another thing to consider is that the surgery may have left some of the tissue adjacent to the implant dennervated and therefore not sensitive to pain. Other things to consider would be the dosage, frequency in terms of penetration depth, pulsed and then all the usually stuff of keeping the head moving.

[thisoldPT]

Yes, thank you for your post. I just think it is strange that forever, we say we should never US over metal implants but that there is no research to say why not, only that we think it would be bad. Yet, we know we shouldn't US over cemented or plastic implants and that there is aparantly research to support this. Take care!