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

Abstract

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 Alleviates Intervertebral Disc Degeneration by Activating Sirt1-Autophagy Signaling Network

“…This occurs via regulation of cell proliferation, differentiation, and maturation, particularly in the treatment of musculoskeletal diseases ( Yang et al, 2021 ; Liu et al, 2022 ). PEMF was reported to improve treatment of various bone diseases, such as, cartilage defects, tendon repair, osteoarthritis, osteoporosis, and so on ( Reilingh et al, 2016 ; Wang et al, 2019 ; Dolkart et al, 2021 ). In recent years, clinical studies have shown that PEMF also has a significant relieving effect on the pain caused by IVD degeneration ( Foley-Nolan et al, 1990 ; Sutbeyaz et al, 2006 ; Alvarez et al, 2019 ).…”

“…To better understand the systemic effects of PEMF on rats, we measured body weight of rats at 2w, 4w and 8w timepoint, and no significance change was observed in each group, which confirmed that PEMF might be a safe noninvasive therapy. It has been shown that PEMF modulates biological functions of many tissues under pathological conditions, including injuries in bones, tendons, muscles and nervous system ( Gessi et al, 2019 ; Huegel et al, 2020 ; Dolkart et al, 2021 ). In this study we mainly focus on the PEMF effect on disc degeneration induced by tail puncture.…”

Applications of Pulsed Electromagnetic Field Therapy in Skeletal-Muscle System: An Integrative Review

“…Recently, Dolkart et al (24) also studied the effects of the continuous pulsed electromagnetic feld (PEMF) on rotator cuff (RC) healing using a rat model. In their study, the authors hypothesized that PEMF application after rotator cuff detachment and repair could produce beneficial effects on biomechanical properties, tissue morphology and bone density.…”

TGF-β1 derived from macrophages contributes to load-induced tendon-bone healing in the murine rotator cuff repair model by promoting chondrogenesis

“… 2 Therefore, TBI injury is common and it is difficult for restoration of injured TBI to the native form due to the slow and incomplete regeneration of the junctional fibrocartilage layer at the healing site. 3 , 4 Therapeutic strategies have been attempted to accelerate the tendon-bone (T-B) healing and promote fibrocartilage regeneration, among which postoperative loading exercise is an important part.…”