The British health agency, the National Institute for Health and Clinical Excellence (NICE), has announced that it supports the use of an ultrasound bone healing device as an alterative to surgery for fractures that are slow to heal. In a press release the NICE stated that, “the available clinical data on the effectiveness of EXOGEN for treating long bone fractures with non-union show high rates of fracture healing.”
Ultrasound Bone Healing Costs Less Says NICE

NICE also examined the manufacturer’s claims that there could be cost benefits from using EXOGEN more widely in the National Health Service (NHS) and found, “EXOGEN is cost saving compared with current management for the treatment of non-union.” England’s National Health Service established NICE to provide evidence-based guidance about medicines, treatments, procedures and devices that represent the best quality care and which offer the best value for the money for NHS.
EXOGEN uses an ultrasound signal to stimulate broken bones to heal naturally. Manufactured by Bioventus LLC, the product has been used worldwide since 1997 and, according to the firm’s press release, is the market leader in the U.S. for fracture stimulation.
Patients using EXOGEN place an ultrasound probe on the skin for 20 minutes a day and the treatment, done at home, is pain free. According to Bioventus, there are no known side effects. Bioventus’ clinical studies have shown EXOGEN to have an equivalent 86% success rate as surgery. EXOGEN’s use in the NHS has, reportedly, been inconsistent with some UK doctors having to persuade hospital managers to fund it.

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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