The effect of induced electric currents on bone after experimental osteotomy in sheep

Law, H. T.; Annan, Iain H.; McCarthy, I. D.; Hughes, S. P. F.; Stead, A. C.; Camburn, MA; Montgomery, H. F.

doi:10.1302/0301-620x.67b3.3873459

Cited by 23 publications

(11 citation statements)

References 14 publications

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“…Similar to Muller's radial osteotomy model, the lack of osteotomy fixation allowed micromovement at the osteotomy gap in this model, and the effect of PEMF stimulation was not detectable due to the unstable mechanical environment. Law et al used a sheep tibial osteotomy model fixed in an "anatomical position" using a nylon plate and nylon screws [22]. In this study, the osteotomy was treated with PEMF stimulation with a frequency of 357 Hz for 24 h per day for LIP to 6 weeks after surgery.…”

Section: Discussionmentioning

confidence: 99%

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Effect of pulsed electromagnetic fields (PEMF) on late‐phase osteotomy gap healing in a canine tibial model

Inoue

Ohnishi

Chen

et al. 2002

Journal Orthopaedic Research

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The effects of a pulsed electromagnetic field (PEMF) on late bone healing phases using an osteotomy gap model in the canine mid-tibia were investigated. A transverse mid-diaphyseal tibial osteotomy with a 2-mm gap was performed unilaterally in 12 adult mixed-breed dogs and stabilized with external fixation. Animals in the variable group ( n = 6) were treated with PEMF for 1 h daily starting 4 weeks after surgery for a total of 8 weeks, whereas no stimulation signal was generated in the control group (n = 6). Functional load-bearing and radiographic assessments were conducted time-sequentially until euthanasia 12 weeks after surgery. Torsional tests and an analysis of undecakified histology were performed on the retrieved mid-tibia1 diaphysis containing the osteotomy site. In the PEMF group, load-bearing of the operated limb recovered earlier when compared to the control group (p < 0.05). Load-bearing in the PEMF group at 8 weeks was greater than in the control group 0, < 0.02). The periosteal callus area increased following surgery at 6 weeks (p < 0.05) and thereafter (p < 0.01) in the PEMF group, while a significant increase was observed at 8 and 10 weeks after surgery (p < 0.05) in the control group. Both the normalized maximum torque and torsional stiffness of the PEMF group were significantly greater than those of the control group (p < 0.04 and p < 0.007, respectively). Histomorphometric analyses revealed greater new-bone formation (p < 0.05) in the osteotomy gap tissue and increased mineral apposition rate (p < 0.04) and decreased porosity in the cortex adjacent to the osteotomy line (p < 0.02) in the PEMF group. PEMF stimulation of 1 h per day for 8 weeks provided faster recovery of load-bearing, a significant increase in new bone formation, and a higher mechanical strength of the healing mid-tibia1 osteotomy. This study revealed enhancing effects of PEMF o n callus formation and maturation in the late-phase of bone healing.

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Section: Discussionmentioning

confidence: 99%

“…I Journul of Ortlzopueclic Research 20 (2002) 1106 1114 1107 bone defect model using the metacarpal bones of the horse [10, 1 I]. Conversely, no benefit of PEMF treatment was found in a dog non-union model and a sheep osteotomy model [14,22]. No prior experiment has been performed to investigate the effects of PEMF on the late-phase of fracture healing.…”

mentioning

confidence: 99%

Effect of pulsed electromagnetic fields (PEMF) on late‐phase osteotomy gap healing in a canine tibial model

Inoue

Ohnishi

Chen

et al. 2002

Journal Orthopaedic Research

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“…In 1985, Law et al investigated the effects of continuous 1.1 mT PEMF treatment for 6 weeks on the rate of healing of transverse, gapless tibial osteotomies in 26 sheep ( Law et al, 1985 ). At 2- and 6-week post-osteotomy, histology staining measured cortical bone and bone callus formation, while radiographs measured the total mineralized callus.…”

Section: Large Animal Studiesmentioning

confidence: 99%

“…Histomorphologic scoring at 8 and 10 weeks post-operatively was significantly increased compared to the control group ( p < .04, p < .05, respectively). Inoue et al have posited that the timing of ES initiation may play a role in significant improvement as their model showed an improvement in bone formation with ES beginning 4 weeks status post osteotomy, while Law et al initiated ES immediately post-operative day zero ( Law et al, 1985 ; Inoue et al, 2002 ).…”

Section: Large Animal Studiesmentioning

confidence: 99%

Electronic Bone Growth Stimulators for Augmentation of Osteogenesis in In Vitro and In Vivo Models: A Narrative Review of Electrical Stimulation Mechanisms and Device Specifications

Nicksic

Donnelly

Hesse

et al. 2022

Front. Bioeng. Biotechnol.

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Since the piezoelectric quality of bone was discovered in 1957, scientists have applied exogenous electrical stimulation for the purpose of healing. Despite the efforts made over the past 60 years, electronic bone growth stimulators are not in common clinical use. Reasons for this include high cost and lack of faith in the efficacy of bone growth stimulators on behalf of clinicians. The purpose of this narrative review is to examine the preclinical body of literature supporting electrical stimulation and its effect on bone properties and elucidate gaps in clinical translation with an emphasis on device specifications and mechanisms of action. When examining these studies, trends become apparent. In vitro and small animal studies are successful in inducing osteogenesis with all electrical stimulation modalities: direct current, pulsed electromagnetic field, and capacitive coupling. However, large animal studies are largely unsuccessful with the non-invasive modalities. This may be due to issues of scale and thickness of tissue planes with varying levels of resistivity, not present in small animal models. Additionally, it is difficult to draw conclusions from studies due to the varying units of stimulation strength and stimulation protocols and incomplete device specification reporting. To better understand the disconnect between the large and small animal model, the authors recommend increasing scientific rigor for these studies and reporting a novel minimum set of parameters depending on the stimulation modality.

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“…There has also been a resurgence in interest in the field of ES for the purpose of bone healing in in vitro studies ( Li et al, 2019 ; Portan et al, 2019 ; Escobar et al, 2020 ; Stephan et al, 2020 ). However, when translating these stimulation protocols and device specifications to large animals and humans, there has been varying levels of success ( Paterson et al, 1977a ; Paterson et al, 1977b ; Miller et al, 1984 ; Law et al, 1985 ; Muttini et al, 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Electrical Stimulation of Acute Fractures: A Narrative Review of Stimulation Protocols and Device Specifications

Nicksic

Donnelly

Verma

et al. 2022

Front. Bioeng. Biotechnol.

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Orthopedic fractures have a significant impact on patients in the form of economic loss and functional impairment. Beyond the standard methods of reduction and fixation, one adjunct that has been explored since the late 1970s is electrical stimulation. Despite robust evidence for efficacy in the preclinical arena, human trials have mixed results, and this technology is not widely accepted. The purpose of this review is to examine the body of literature supporting electrical stimulation for the purpose of fracture healing in humans with an emphasis on device specifications and stimulation protocols and delineate a minimum reporting checklist for future studies of this type. We have isolated 12 studies that pertain to the administration of electrical stimulation for the purpose of augmenting fracture healing in humans. Of these, one was a direct current electrical stimulation study. Six studies utilized pulsed electromagnetic field therapy and five used capacitive coupling. When examining these studies, the device specifications were heterogenous and often incomplete in what they reported, which rendered studies unrepeatable. The stimulation protocols also varied greatly study to study. To demonstrate efficacy of electrical stimulation for fractures, the authors recommend isolating a fracture type that is prone to nonunion to maximize the electrical stimulation effect, a homogenous study population so as to not dilute the effect of electrical stimulation, and increasing scientific rigor in the form of pre-registration, blinding, and sham controls. Finally, we introduce the critical components of minimum device specification reporting for repeatability of studies of this type.

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The effect of induced electric currents on bone after experimental osteotomy in sheep

Cited by 23 publications

References 14 publications

Effect of pulsed electromagnetic fields (PEMF) on late‐phase osteotomy gap healing in a canine tibial model

Effect of pulsed electromagnetic fields (PEMF) on late‐phase osteotomy gap healing in a canine tibial model

Electronic Bone Growth Stimulators for Augmentation of Osteogenesis in In Vitro and In Vivo Models: A Narrative Review of Electrical Stimulation Mechanisms and Device Specifications

Electrical Stimulation of Acute Fractures: A Narrative Review of Stimulation Protocols and Device Specifications

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