Comparative study of the use of electromagnetic fields in patients with pseudoarthrosis of tibia treated by intramedullary nailing

Cebrián, Juan Luis; Gallego, Pilar; Francés, Alberto; Sánchez, P.; Manrique, Elena; Marco, Fernando; López-Durán, L.

doi:10.1007/s00264-009-0806-1

Cited by 16 publications

(11 citation statements)

References 24 publications

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“…With frequencies over 33 Hz, no effect on primary human osteoblast viability and function were observed [22], this might explain the lacking effect of the PEMF (75 Hz) in the study of Reilingh et al [17]. In another study, however, a higher rate of osseous consolidation after intramedullary nailing of tibial pseudarthrosis was shown, when patients were additionally exposed to ELF-PEMF (75 Hz) [37]. Lower frequency ELF-PEMF (15 Hz) proved to be effective in treating non-unions of long and non-long bone fractures [38].…”

Section: Discussionmentioning

confidence: 99%

Pulsed Electromagnetic Field Therapy Improves Osseous Consolidation after High Tibial Osteotomy in Elderly Patients—A Randomized, Placebo-Controlled, Double-Blind Trial

Ziegler

Nüssler

Wilbrand

et al. 2019

JCM

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Extremely low-frequency pulsed electromagnetic field (ELF-PEMF) therapy is proposed to support bone healing after injuries and surgical procedures, being of special interest for elderly patients. This study aimed at investigating the effect of a specific ELF-PEMF, recently identified to support osteoblast function in vitro, on bone healing after high tibial osteotomy (HTO). Patients who underwent HTO were randomized to ELF-PEMF or placebo treatment, both applied by optically identical external devices 7 min per day for 30 days following surgery. Osseous consolidation was evaluated by post-surgical X-rays (7 and 14 weeks). Serum markers were quantified by ELISA. Data were compared by a two-sided t-test (α = 0.05). Device readouts showed excellent therapy compliance. Baseline parameters, including age, sex, body mass index, wedge height and blood cell count, were comparable between both groups. X-rays revealed faster osseous consolidation for ELF-PEMF compared to placebo treatment, which was significant in patients ≥50 years (∆mean = 0.68%/week; p = 0.003). Findings are supported by post-surgically increased bone-specific alkaline phosphatase serum levels following ELF-PEMF, compared to placebo (∆mean = 2.2 µg/L; p = 0.029) treatment. Adverse device effects were not reported. ELF-PEMF treatment showed a tendency to accelerate osseous consolidation after HTO. This effect was stronger and more significant for patients ≥50 years. This ELF-PEMF treatment might represent a promising adjunct to conventional therapy supporting osseous consolidation in elderly patients. Level of Evidence: I.

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Section: Discussionmentioning

confidence: 99%

Pulsed Electromagnetic Field Therapy Improves Osseous Consolidation after High Tibial Osteotomy in Elderly Patients—A Randomized, Placebo-Controlled, Double-Blind Trial

Ziegler

Nüssler

Wilbrand

et al. 2019

JCM

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“…PEMFs enhance proliferation and differentiation of osteoblasts, stimulating anabolic bone proteins (Barnaba et al, ; Esmail et al, ; Li et al, ; Zhai et al, ), and this aspect has already been investigated in vivo (Fini et al, ; Benazzo et al, ; Veronesi, Cadossi et al, ). For such evidences, PEMFs are employed in clinical settings for improving bone fracture healing, treating delayed or non‐unions and stimulating osteointegration in primary arthroplasty or revision surgeries (Cebrián et al, ; Dallari et al, ; Massari, Caruso, Sollazzo, & Setti, ).However, until now, no literature studies have yet evaluated PEMFs stimulation on PBMCs exposed to UHMWPE for counteracting wear debris mediated osteclastogenesis. Some literature studies, without particle exposure, confirm that PEMFs stimulation reduces OC number and Nfatc1 expression in mice osteoclast‐like cells (He et al, ), in rat bone marrow cells (Chang, Hong‐Shong Chang, Wu, & Shih, ; Chang, Chang, Tsai, & Shih, ), or in RAW264.7 cells (Zhang et al, ) and increases OC apoptosis (Chen et al, ).…”

Section: Discussionmentioning

confidence: 99%

Effects of pulsed electromagnetic fields and platelet rich plasma in preventing osteoclastogenesis in an in vitro model of osteolysis

Tschon

Veronesi

Contartese

et al. 2017

Journal Cellular Physiology

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Osteolysis is the main limiting cause for the survival of an orthopedic prosthesis and is accompanied by an enhancement in osteoclastogenesis and inflammation, due by wear debris formation. Unfortunately therapeutic treatments, besides revision surgery, are not available. The aim of the present study was to evaluate the effects of Pulsed Electro Magnetic Fields (PEMFs) and platelet rich plasma (PRP), alone or in combination, in an in vitro model of osteolysis. Rats peripheral blood mononuclear cells were cultured on Ultra High Molecular Weight Polyethylene particles and divided into four groups of treatments: (1) PEMF stimulation (12 hr/day, 2.5 mT, 75 Hz, 1.3 ms pulse duration); (2) 10% PRP; (3) combination of PEMFs, and PRP; (4) no treatment. Treatments were performed for 3 days and cell viability, osteoclast number, expression of genes related to osteoclastogenesis and inflammation and production of pro-inflammatory cytokines were assessed up to 14 days. PEMF stimulation exerted best results because it increased cell viability at early time points and counteracted osteoclastogenesis at 14 days. On the contrary, PRP increased osteoclastogenesis and reduced cell viability in comparison to PEMFs alone. The combination of PEMFs and PRP increased cell viability over time and reduced osteoclastogenesis in comparison to PRP alone. However, these positive results did not exceed the level achieved by PEMF alone. At longer time points PEMF could not counteract osteoclastogenesis increased by PRP. Regarding inflammation, all treatments maintained the production of pro-inflammatory cytokines at low level, although PRP increased the level of interleukin 1 beta.

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“…The effects of an intramedullary implant with static magnetic field have not been established. The difference in our study is the application of the magnetic field in an implant [7].…”

Section: Discussionmentioning

confidence: 99%

The effect of an intramedullary implant with a static magnetic field on the healing of the osteotomised rabbit femur

Aydın

Bezer

2010

International Orthopaedics (SICOT)

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Static magnetic fields are a type of electromagnetic fields used in clinical practice. To ascertain what effect a static magnetic intramedullary device implanted in the rabbit femur had on fracture healing, 20 male New Zealand white rabbits with magnetic/nonmagnetic intramedullary implants were examined histologically, radiologically and for bone mineral density. Three groups were constituted according to the poles of the magnets. During surgery the intramedullary device was driven into the medulla. A femoral osteotomy was created with a mini Gigli wire at the centre point of the rod. Radiographs were obtained at the second and fourth weeks. Histological examination and bone mineral density were evaluated at the fourth week. The results of this study verified that an intramedullary implant with a static magnetic field improves bone healing in the first two weeks radiologically and that the configuration difference in magnetic poles has an effect on bone quality. Static magnetic fields have minor effects on bone mineral density values.

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Comparative study of the use of electromagnetic fields in patients with pseudoarthrosis of tibia treated by intramedullary nailing

Cited by 16 publications

References 24 publications

Pulsed Electromagnetic Field Therapy Improves Osseous Consolidation after High Tibial Osteotomy in Elderly Patients—A Randomized, Placebo-Controlled, Double-Blind Trial

Pulsed Electromagnetic Field Therapy Improves Osseous Consolidation after High Tibial Osteotomy in Elderly Patients—A Randomized, Placebo-Controlled, Double-Blind Trial

Effects of pulsed electromagnetic fields and platelet rich plasma in preventing osteoclastogenesis in an in vitro model of osteolysis

The effect of an intramedullary implant with a static magnetic field on the healing of the osteotomised rabbit femur

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