Bone bioelectricity: What have we learned in the past 160 years?

Abstract

The direct relationship between bone strain and electric fields has spurred continual interest in the field of bioelectricity over the past 160 years. It has been reported that stress-generated potentials alter cell proliferation and extracellular matrix secretion. The observation that endogenous electrical signals facilitate osteoinduction has lead to high production of electrical stimulation devices to fix bone defects. Despite the reported 100,000 nonunions healed as of 1990 with electrical stimulation, skepticism due to lack of homogeneity with trial design and dosage still exists within the scientific community. It is the purpose of this review to assess the bioelectric phenomenon of bone as it applies to piezoelectricity, fracture healing, and overall changes in bone metabolism which occur with controlled electrical stimulation.

Intraoperative measurement of bone electrical potential: a piece in the puzzle of understanding fracture healing

“…More comprehensive understanding of the bone electrical potential, could improve fracture treatment. This is confirmed by some of the latest review articles in this field 1,12,16,17 . Significant differences in potentials measured in dried, recently excised and living bone, confirm the value of the in vivo research, especially in humans 18 .…”

“…These controversies complicate clinical application of bone electrical stimulation, despite numerous studies that confirm the positive effect. One of the main objections is a question of dosage, so the research on bone electrical potential is still current 1,17 . Results from this study may help to clarify this issue.…”

“…This process is closely related to the electrical field that is induced at the same time 1,2 . Strain changes the electrical potential of bone: parts exposed to the compression force develop negative potential, and parts subjected to the tension force positive potential.…”

“…Isaacson and Bloebaum provided an excellent overview of the successful application of electricity. Nevertheless, scepticism, due to the lack of homogeneity with trial design and dosage, still exist in scientific community 1 .…”

The Electrical Response to Injury: Molecular Mechanisms and Wound Healing

“…95 Clinical application of currents of the same polarity and similar magnitude to the endogenous bone fracture currents have been successful in treating chronic nonunions in fractured bones. 98 Bone marrow cells involved in bone regeneration and healing respond to physiological DC EFs by directional migration. 99 Thus, the structural integrity of bone is maintained by anatomical forces that are electrical in nature.…”