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

2019 ◽  
Vol 8 (11) ◽  
pp. 2008 ◽  
Author(s):  
Patrick Ziegler ◽  
Andreas K. Nussler ◽  
Benjamin Wilbrand ◽  
Karsten Falldorf ◽  
Fabian Springer ◽  
...  
Keyword(s):  
Electromagnetic Field ◽  
Elderly Patients ◽  
High Tibial Osteotomy ◽  
Bone Healing ◽  
Placebo Treatment ◽  
Tibial Osteotomy ◽  
X Rays ◽  
Pulsed Electromagnetic Field ◽  
Pulsed Electromagnetic ◽  
Pemf Treatment

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.

scholarly journals Pulsed electromagnetic field stimulation may improve fusion rates in cervical arthrodesis in high-risk populations

2018 ◽  
Vol 7 (2) ◽  
pp. 124-130 ◽  
Author(s):  
D. Coric ◽  
D. E. Bullard ◽  
V. V. Patel ◽  
J. T. Ryaby ◽  
B. L. Atkinson ◽  
...  
Keyword(s):  
Electromagnetic Field ◽  
Risk Factor ◽  
High Risk ◽  
Clinical Risk Factor ◽  
Field Stimulation ◽  
Pulsed Electromagnetic Field ◽  
Exact Test ◽  
High Risk Populations ◽  
Pulsed Electromagnetic ◽  
Pemf Treatment

Objectives Pulsed electromagnetic field (PEMF) stimulation was evaluated after anterior cervical discectomy and fusion (ACDF) procedures in a randomized, controlled clinical study performed for United States Food and Drug Administration (FDA) approval. PEMF significantly increased fusion rates at six months, but 12-month fusion outcomes for subjects at elevated risk for pseudoarthrosis were not thoroughly reported. The objective of the current study was to evaluate the effect of PEMF treatment on subjects at increased risk for pseudoarthrosis after ACDF procedures. Methods Two evaluations were performed that compared fusion rates between PEMF stimulation and a historical control (160 subjects) from the FDA investigational device exemption (IDE) study: a post hoc (PH) analysis of high-risk subjects from the FDA study (PH PEMF); and a multicentre, open-label (OL) study consisting of 274 subjects treated with PEMF (OL PEMF). Fisher’s exact test and multivariate logistic regression was used to compare fusion rates between PEMF-treated subjects and historical controls. Results In separate comparisons of PH PEMF and OL PEMF groups to the historical control group, PEMF treatment significantly (p < 0.05, Fisher’s exact test) increased the fusion rate at six and 12 months for certain high-risk subjects who had at least one clinical risk factor of being elderly, a nicotine user, osteoporotic, or diabetic; and for those with at least one clinical risk factor and who received at least a two- or three-level arthrodesis. Conclusion Adjunctive PEMF treatment can be recommended for patients who are at high risk for pseudoarthrosis. Cite this article: D. Coric, D. E. Bullard, V. V. Patel, J. T. Ryaby, B. L. Atkinson, D. He, R. D. Guyer. Pulsed electromagnetic field stimulation may improve fusion rates in cervical arthrodesis in high-risk populations. Bone Joint Res 2018;7:124–130. DOI: 10.1302/2046-3758.72.BJR-2017-0221.R1.

scholarly journals Pulsed electromagnetic field therapy improves tendon-to-bone healing in a rat rotator cuff repair model

2016 ◽  
Vol 35 (4) ◽  
pp. 902-909 ◽  
Author(s):  
Jennica J. Tucker ◽  
James M. Cirone ◽  
Tyler R. Morris ◽  
Courtney A. Nuss ◽  
Julianne Huegel ◽  
...  
Keyword(s):  
Electromagnetic Field ◽  
Rotator Cuff ◽  
Bone Healing ◽  
Rotator Cuff Repair ◽  
Pulsed Electromagnetic Field ◽  
Field Therapy ◽  
Pulsed Electromagnetic ◽  
Pulsed Electromagnetic Field Therapy ◽  
Cuff Repair

scholarly journals Novel protective effects of pulsed electromagnetic field ischemia/reperfusion injury rats

2016 ◽  
Vol 36 (6) ◽  
Author(s):  
Fenfen Ma ◽  
Wenwen Li ◽  
Xinghui Li ◽  
Ba Hieu Tran ◽  
Rinkiko Suguro ◽  
...  
Keyword(s):  
Electromagnetic Field ◽  
Ischemia Reperfusion Injury ◽  
Cell Lymphoma ◽  
Ischemia Reperfusion ◽  
B Cell Lymphoma ◽  
Protective Effects ◽  
Pulsed Electromagnetic Field ◽  
Ischaemia Reperfusion ◽  
Pulsed Electromagnetic ◽  
Pemf Treatment

Pulsed electromagnetic field (PEMF) treatment protected ischaemia/reperfusion (I/R) injury from apoptosis via B-cell lymphoma 2 (Bcl-2), Bax and nitric oxide (NO) releasing.

scholarly journals Increases in microvascular perfusion and tissue oxygenation via pulsed electromagnetic fields in the healthy rat brain

2015 ◽  
Vol 122 (5) ◽  
pp. 1239-1247 ◽  
Author(s):  
Denis E. Bragin ◽  
Gloria L. Statom ◽  
Sean Hagberg ◽  
Edwin M. Nemoto
Keyword(s):  
Nitric Oxide ◽  
Electromagnetic Field ◽  
Brain Injury ◽  
Tissue Oxygenation ◽  
Microvascular Perfusion ◽  
Pulsed Electromagnetic Fields ◽  
Field Stimulation ◽  
Pulsed Electromagnetic Field ◽  
Pulsed Electromagnetic ◽  
Pemf Treatment

OBJECT High-frequency pulsed electromagnetic field stimulation is an emerging noninvasive therapy being used clinically to facilitate bone and cutaneous wound healing. Although the mechanisms of action of pulsed electromagnetic fields (PEMF) are unknown, some studies suggest that its effects are mediated by increased nitric oxide (NO), a well-known vasodilator. The authors hypothesized that in the brain, PEMF increase NO, which induces vasodilation, enhances microvascular perfusion and tissue oxygenation, and may be a useful adjunct therapy in stroke and traumatic brain injury. To test this hypothesis, they studied the effect of PEMF on a healthy rat brain with and without NO synthase (NOS) inhibition. METHODS In vivo two-photon laser scanning microscopy (2PLSM) was used on the parietal cortex of rat brains to measure microvascular tone and red blood cell (RBC) flow velocity in microvessels with diameters ranging from 3 to 50 μm, which includes capillaries, arterioles, and venules. Tissue oxygenation (reduced nicotinamide adenine dinucleotide [NADH] fluorescence) was also measured before and for 3 hours after PEMF treatment using the FDA-cleared SofPulse device (Ivivi Health Sciences, LLC). To test NO involvement, the NOS inhibitor NG-nitro-l-arginine methyl ester (L-NAME) was intravenously injected (10 mg/kg). In a time control group, PEMF were not used. Doppler flux (0.8-mm probe diameter), brain and rectal temperatures, arterial blood pressure, blood gases, hematocrit, and electrolytes were monitored. RESULTS Pulsed electromagnetic field stimulation significantly dilated cerebral arterioles from a baseline average diameter of 26.4 ± 0.84 μm to 29.1 ± 0.91 μm (11 rats, p < 0.01). Increased blood volume flow through dilated arterioles enhanced capillary flow with an average increase in RBC flow velocity by 5.5% ± 1.3% (p < 0.01). Enhanced microvascular flow increased tissue oxygenation as reflected by a decrease in NADH autofluorescence to 94.7% ± 1.6% of baseline (p < 0.05). Nitric oxide synthase inhibition by L-NAME prevented PEMF-induced changes in arteriolar diameter, microvascular perfusion, and tissue oxygenation (7 rats). No changes in measured parameters were observed throughout the study in the untreated time controls (5 rats). CONCLUSIONS This is the first demonstration of the acute effects of PEMF on cerebral cortical microvascular perfusion and metabolism. Thirty minutes of PEMF treatment induced cerebral arteriolar dilation leading to an increase in microvascular blood flow and tissue oxygenation that persisted for at least 3 hours. The effects of PEMF were mediated by NO, as we have shown in NOS inhibition experiments. These results suggest that PEMF may be an effective treatment for patients after traumatic or ischemic brain injury. Studies on the effect of PEMF on the injured brain are in progress.

scholarly journals Effects of focused continuous pulsed electromagnetic field therapy on early tendon-to-bone healing

2021 ◽  
Vol 10 (5) ◽  
pp. 298-306
Author(s):  
Oleg Dolkart ◽  
Efi Kazum ◽  
Yoav Rosenthal ◽  
Osnat Sher ◽  
Guy Morag ◽  
...  
Keyword(s):  
Electromagnetic Field ◽  
Bone Healing ◽  
Long Bone ◽  
Type I ◽  
Pulsed Electromagnetic Field ◽  
Mineral Density ◽  
Collagen Organization ◽  
Supraspinatus Tear ◽  
Bone Properties ◽  
Pulsed Electromagnetic

Aims Rotator cuff (RC) tears are common musculoskeletal injuries which often require surgical intervention. Noninvasive pulsed electromagnetic field (PEMF) devices have been approved for treatment of long-bone fracture nonunions and as an adjunct to lumbar and cervical spine fusion surgery. This study aimed to assess the effect of continuous PEMF on postoperative RC healing in a rat RC repair model. Methods A total of 30 Wistar rats underwent acute bilateral supraspinatus tear and repair. A miniaturized electromagnetic device (MED) was implanted at the right shoulder and generated focused PEMF therapy. The animals’ left shoulders served as controls. Biomechanical, histological, and bone properties were assessed at three and six weeks. Results Extension of the tendon from preload to the maximum load to failure was significantly better in the PEMF-treated shoulders at three weeks compared to controls (p = 0.038). The percentage strain was significantly higher in the PEMF group at both timepoints (p = 0.037). Collagen organization was significantly better (p = 0.034) as was tissue mineral density in the PEMF-treated group at three weeks (p = 0.028). Tendon immunohistochemistry revealed a prominent increase in type I collagen at the repair site at three weeks following continuous PEMF treatment compared with controls. None of the other tested parameters differed between the groups. Conclusion MED-generated PEMF may enhance early postoperative tendon-to-bone healing in an acute rat supraspinatus detachment and repair model. Superior biomechanical elasticity parameters together with better collagen organization suggest improved RC healing. Cite this article: Bone Joint Res 2021;10(5):298–306.

Pulsed electromagnetic field (PEMF) treatment for fracture healing

2009 ◽  
Vol 20 (4) ◽  
pp. 423-428 ◽  
Author(s):  
PRJVC Boopalan ◽  
Samuel B Chittaranjan ◽  
Ramadass Balamurugan ◽  
NS Nandakumar ◽  
A Sabareeswaran ◽  
...  
Keyword(s):  
Electromagnetic Field ◽  
Fracture Healing ◽  
Pulsed Electromagnetic Field ◽  
Pulsed Electromagnetic ◽  
Pemf Treatment

scholarly journals Pulsed-electromagnetic-field induced osteoblast differentiation requires activation of genes downstream of adenosine receptors A2A and A3

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247659
Author(s):  
Niladri S. Kar ◽  
Daniel Ferguson ◽  
Nianli Zhang ◽  
Erik I. Waldorff ◽  
James T. Ryaby ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Electromagnetic Field ◽  
Adenosine Receptors ◽  
Osteoblast Differentiation ◽  
Molecular Mechanisms ◽  
Expression Profiles ◽  
Osteoblastic Differentiation ◽  
Pulsed Electromagnetic Field ◽  
Pulsed Electromagnetic ◽  
Pemf Treatment

Pulsed-electromagnetic-field (PEMF) treatment was found to enhance cellular differentiation of the mouse preosteoblast, MC3T3-E1, to a more osteoblastic phenotype. Differentiation genes such as Alp, BSPI, cFos, Ibsp, Osteocalcin, Pthr1 and Runx2 showed increased expression in response to PEMF stimulation. Detailed molecular mechanisms linking PEMF to the activation of these genes are limited. Two adenosine receptors known to be modulated in response to PEMF, Adora2A and Adora3, were functionally impaired by CRISPR-Cas9-mediated gene disruption, and the consequences of which were studied in the context of PEMF-mediated osteoblastic differentiation. Disruption of Adora2A resulted in a delay of Alp mRNA expression, but not alkaline phosphatase protein expression, which was similar to that found in wild type cells. However, Adora3 disruption resulted in significantly reduced responses at both the alkaline phosphatase mRNA and protein levels throughout the PEMF stimulation period. Defects observed in response to PEMF were mirrored using a chemically defined growth and differentiation-inducing media (DM). Moreover, in cells with Adora2A disruption, gene expression profiles showed a blunted response in cFos and Pthr1 to PEMF treatment; whereas cells with Adora3 disruption had mostly blunted responses in AlpI, BSPI, Ibsp, Osteocalcin and Sp7 gene activation. To demonstrate specificity for Adora3 function, the Adora3 open reading frame was inserted into the ROSA26 locus in Adora3 disrupted cells culminating in rescued PEMF responsiveness and thereby eliminating the possibility of off-target effects. These results lead us to propose that there are complementary and parallel positive roles for adenosine receptor A2A and A3 in PEMF-mediated osteoblast differentiation.

scholarly journals Analysis and quantification of bone healing after open wedge high tibial osteotomy

2019 ◽  
Vol 131 (23-24) ◽  
pp. 587-598 ◽  
Author(s):  
Elena Nemecek ◽  
Catharina Chiari ◽  
Alexander Valentinitsch ◽  
Franz Kainberger ◽  
Gerhard Hobusch ◽  
...  
Keyword(s):  
High Tibial Osteotomy ◽  
Bone Healing ◽  
Imaging Techniques ◽  
Phase 1 ◽  
Computer Software ◽  
Ct Scans ◽  
Study Phase ◽  
Tibial Osteotomy ◽  
X Rays ◽  
Mineral Density

Summary Background The aim of this study was to analyze radiographic imaging techniques and to quantify bone ossification in the osteotomy gap after high tibial osteotomy. Material and methods Study phase 1: high tibial osteotomy was performed on six lower extremities of human body donors and experimental X‑rays and computed tomography (CT) scans were applied. Different techniques were evaluated by three specialists for best representation of the osteotomy gap. Study phase 2: optimized radiological techniques were used for follow-up on 12 patients. The radiographs were examined by 3 specialists measuring 10 different parameters. The CT scans were analyzed with semiautomatic computer software for quantification of bone ossification. Results The osteotomy gap was best represented in 30° of flexion in the knee and 20° internal rotation of the leg. There were significant changes of the medial width over time (p < 0.019) as well as of the length of fused osteotomy, the Schröter score, sclerosis, trabecular structure and zone area measurements. Sclerosis, medial width of the osteotomy and area measurements were detected as reproducible parameters. Bone mineral density was calculated using CT scans, showing a significantly higher value 12 weeks postoperatively (112.5 mg/cm3) than at baseline (54.6 mg/cm3). The ossification of the gap was visualized by color coding. Conclusion Sclerosis and medial width of the osteotomy gap as well as area measurements were determined as reproducible parameters for evaluation of bone healing. Quantification of bone ossification can be calculated with CT scans using a semiautomatic computer program and should be used for research in bone healing.

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