Pulsed electromagnetic field therapy results in healing of full thickness articular cartilage defect

Abstract

This study aimed to determine the efficacy of PEMF (pulsed electromagnetic field) treatment in experimental osteochondral defect healing in a rabbit model. The study was conducted on 12 New Zealand white rabbits. Six rabbits formed the study group and six rabbits the control group. The right knee joints of all 12 animals were exposed and a 3.5-mm diameter osteochondral defect was created in the trochlear groove. The defect was filled with calcium phosphate scaffold. Six animals from the study group were given PEMF of one hour duration once a day for six weeks with set parameters for frequency of 1 Hz, voltage 20 V, sine wave and current ±30 mA. At six weeks the animals were sacrificed and histological evaluation was done using H&E, Safranin O, Maissons trichrome staining and immunohistochemistry for type 2 collagen. The quality of the repair tissue was graded and compared between groups with the Wakitani histological grading scale and a statistical analysis was done. The total histological score was significantly better in the study group (p =0.002) with regeneration similar to adjacent normal hyaline cartilage. Immunohistochemistry for collagen type II was positive in the study group. PEMF stimulation of osteochondral defects with calcium phosphate scaffold is effective in hyaline cartilage formation. PEMF is a non-invasive and cost effective adjuvant treatment with salvage procedures such as abrasion chondroplasty and subchondral drilling.

Chondrogenic Priming at Reduced Cell Density Enhances Cartilage Adhesion of Equine Allogeneic MSCs - a Loading Sensitive Phenomenon in an Organ Culture Study with 180 Explants

“…Alternative approaches to improve regeneration capacity in explants treated with PEMFs may include: 1) increasing exposure amplitude; 2) increasing exposure duration; 3) increasing number of exposures to a value greater than 1; 4) exposing MSC-seeded explants directly to PEMFs or; 5) a combination of the above. In fact, Esposito et al have previously reported induction of chondrogenic differentiation upon PEMF treatment [14] and several in vivo studies have demonstrated beneficial effects of this therapy on clinical symptoms of animals and humans with osteoarthritis [11,12]. It has to be mentioned though that these studies applied 6 weeks of daily treatment of the injured joint, whereas our study employed single 10 minute prestimulation of chondrogenically induced MSCs and unstimulated ex vivo cartilage explants.…”

“…Recently, it has been shown that pulsed electromagnetic field (PEMF) treatment of injured rabbit knees can significantly improve histological scores and hyaline cartilage formation after 6 weeks of daily PEMF treatment for one hour a day [11]. In 28 elderly humans with bilateral knee osteoarthritis, PEMF stimulation at 3 times per week over 6 weeks significantly improved pain, stiffness, and physical function in comparison to the untreated contralateral joint [12].…”

Effects of low frequency electromagnetic fields on the chondrogenic differentiation of human mesenchymal stem cells

“…During subchondral drilling, bone marrow cells migrate and endogenous growth factors are released from subchondral bone [Khan et al, 2010]. These endogenous growth factors may be able to initiate differentiation of bone marrow cells and cause osteochondral defects to profit from EMF stimulation [Boopalan et al, 2010].…”

Delayed Union of Scaphoid Fracture and Effectiveness of Pulsed Electromagnetic Fields: A Case Report and Review of the Literature

“…However, to the best of our knowledge, there are scarce reports, if any, on scaphoid fractures (4,5). The objective of this case report is to show delayed union fracture as a common complication of scaphoid fracture and to postulate PEMF as an effective treatment option for such a condition, reflected by our clinical and radiological evaluations and supported by a thorough review of the literature.…”