In situ electrical stimulation for enhanced bone growth: A mini‐review

Abstract

The role of electrical stimuli in directing cellular activities during natural tissue healing and regeneration process has been well recognized. This observation has prompted the development and use of exogenous electrical stimulations in the treatment of delayed unions and non‐unions of bone fracture in different parts of the human skeletal system. Considerable amount of clinical evidences has also been generated on the benefits of exogenous bone growth stimulators. However, the clinical efficacy and safety of these exogenous electrical stimulating methods are being argued to be inconsistent and inconclusive, due to lack of sufficient number of well‐controlled, randomized clinical studies. As a result, there has been significant interest in the development of smart biomaterials, which can generate in situ electrical stimuli, for accelerated bone repair, healing and regeneration. These smart biomaterials are essentially either composite biomaterials containing electrically active materials or biomaterials that can be polarized. The primary objective of this mini review was to provide an overview of different exogenous electrical stimulation methods and biocomposites for in situ stimulation, which can be used for bone growth and healing. The first part is focused on exogenous stimulation methods, and the second part discusses the use of biocomposites containing electrically active materials such as piezoelectric materials and multiferroic materials for accelerated repair and regeneration of bone.

Morphology of Nanostructured Tantalum Oxide Controls Stem Cell Differentiation and Improves Corrosion Behavior

“…It is interesting to note that tantalum oxide presents piezoelectric properties, , where it generates electricity upon the application of stress. It was demonstrated in the literature that the piezoelectric effect of implants, such as barium titanate and zinc oxide, could promote bone formation and healing in vitro and in vivo. , Perhaps the piezoelectric effect, alongside surface nanotopography and wetting behavior, may play a stimulating supporting role in osseointegration upon the implantation of anodized tantalum implants into the body. Once the biological response is characterized in vivo, translation of the anodization technology for real orthopedic implant surfaces is required.…”

Researching progress on bio-reactive electrogenic materials with electrophysiological activity for enhanced bone regeneration

“…Electrical stimulation, such as pulsed electromagnetic field, pulsed alternating current, direct current, and electrostatic field, has been proven to be beneficial to the growth and repair of new bone in many animal experiments and clinical practices ( Khatua et al, 2020 ; Sahm et al, 2020 ; Devet et al, 2021 ). Clinically, electrical stimulation osteogenesis can be roughly divided into implantation and non-implantation methods.…”

Gathering Evidence to Leverage Musculoskeletal Magnetic Stimulation Towards Clinical Applicability

“…Direct electric current (DC) stimulation, requiring direct contact of the cathode with injured bone tissues or bone cell cultures used as research models, has been widely studied for bone healing. [46][47][48] However, the invasiveness of DC stimulators is inherently associated with infections, inflammation, soft tissue discomfort, or cathode rupture. [47] Contrariwise, non-invasive stimulation through EF and/or MF has significant advantages, including the absence of toxic chemicals' formation and immune responses in host tissues, besides requiring simpler designs and involving little tissue handling.…”

“…[46][47][48] However, the invasiveness of DC stimulators is inherently associated with infections, inflammation, soft tissue discomfort, or cathode rupture. [47] Contrariwise, non-invasive stimulation through EF and/or MF has significant advantages, including the absence of toxic chemicals' formation and immune responses in host tissues, besides requiring simpler designs and involving little tissue handling. [49] Further, devices incorporating non-invasive stimulators allow both repeated treatment and monitoring of target regions.…”