Mechanism of Action
Osteoblasts are shown to respond to ultrasound stimulation as they begin to initiate the intracellular healing cascade.2

Only EXOGEN◊ Ultrasound has been proven to activate receptors called integrins, which are found on a wide range of cells crucial to bone healing3,4

EXOGEN◊ Ultrasound also upregulates proteins essential to bone repair: osteocalcin, osteonectin I, and osteopontin; other bone-healing enzymes, genes, and growth factors: alkaline phosphatase, MMP-13, and IGF-12
1. Low-intensity pulsed ultrasound
2. Data on file. MG Bachem, 2007.
3 Pounder NM, Harrison AJ. Low intensity pulsed ultrasound for fracture healing: a review of the clinical evidence and the associated biological mechanism of action. Ultrasonics. 2008;48(4):330-338.
4 Zhou S, Schmelz A, Seufferlein T, Li Y, Zhao J, Bachem MG. Molecular mechanisms of low intensity pulsed ultrasound on human skin fibroblasts. J Biol Chem. 2004;279(52):54463-54469.
5 Sant'Anna EF, Leven RM, Virdi AS, Sumner DR. Effect of low intensity pulsed ultrasound and BMP-2 on rat bone marrow stromal cell gene expression. J Orthop Res. 2005;23(3):646-652.
6 Naruse K, Miyauchi A, Itoman M, Mikuni-Takagaki Y (2003) Distinct anabolic response of osteoblast to low-intensity pulsed ultrasound. J. Bone & Miner. Res. 18:2:360-369.
7 Chen Y-J, Wang C-J, Yang KD, et al. (2003) Pertussis toxin-sensitive Gai protein and ERK dependent pathways mediate ultrasound promotion of osteogenic transcription in human osteoblasts. FEBS Lett 554:154-158.
8 Wang F-S, Kuo Y-R, Wang C-J, et al. (2004) Nitric oxide mediates ultrasound-induced hypoxia-inducible factor-1a activation and vascular endothelial growth factor - A expression in human osteoblasts. Bone 35:114-123.
9 Premarket Approval P900009/Supplement 6. Smith & Nephew
Contraindications: There are no known contraindications for the EXOGEN◊ device. Warnings and precautions pertaining to the treatment of either condition may be found at www.exogen.com or by calling 1-800-836-4080.
† A non-union is considered to be established when the fracture site shows no visibly progressive signs of healing. Rx only.