The role of electrical stimulation in the management of avascular necrosis of the femoral head in adults: a systematic review

Abstract

BackgroundAvascular necrosis of the femoral head causes significant morbidity and occurs in up to 20,000 people per year. A variety of nonoperative and operative measures have been trialled however a definitive treatment algorithm is yet to be established. Young adults in many cases have undergone multiple surgical procedures in their lifetime with increasing risks of complications. Less invasive techniques may help reduce the number of operations required and positively influence the natural history of the disease process. Our aim was to navigate the literature and examine the results of electrical stimulation of the femoral head in avascular necrosis.MethodsThe following defined search strategy was used to perform a systematic review using MEDLINE and Google Scholar databases: ((avascular necrosis) OR (osteonecrosis)) AND (femoral head) AND ((electrical stimulation) OR (capacitive coupling) OR (pulsed electromagnetic fields)). Articles were reviewed and data compiled into tables for analysis.ResultsFourty six articles were identified with a total of 10 articles meeting the inclusion criteria. 8 articles were prospective studies and 2 were retrospective. Early Ficat stages showed the best responses to treatment via pulsed electromagnetic fields with improvements in both clinical and radiographic parameters. Direct current and capacitative coupling have had a more ambiguous outcome.ConclusionsPulsed electromagnetic fields may have a role in the management of early avascular necrosis. The paucity of clinical studies into this technique indicates a need for further studies.

Microarray profiling of circular RNAs in steroid-associated osteonecrosis of the femoral head

“…[ 1 , 2 ] Increased incidence of ONFH was reported over the past decade, and an estimated of 20,000 to 30,000 and 150,000 to 200,000 new cases of ONFH were respectively presented annually in the United States and China. [ 3 , 4 ] Moreover, a total of 8.12 million ONFH patients in China remains a challenge to surgeons. [ 5 ] As the main form of ONFH, steroid-associated osteonecrosis of the femoral head (SONFH) is one of the most common and severe complications following corticosteroid treatment.…”

Effectiveness of neuromuscular electrical stimulation and ibuprofen for pain caused by necrosis of the femoral head

“…Previous study has reported that electrical stimulation can be used to treat a variety of pain conditions, especially for NMES. [ 18 – 24 ] However, few studies focused on using electrical stimulation to treat patients with NFH. As far as we know, no study has explored the effectiveness of NMES for the treatment of NFH.…”

“…[ 11 – 18 ] These options include medications, surgical treatments, and other alternative interventions, such as Chinese herbal medicine, acupuncture, rest, extracorporeal shock wave therapy, and electrical stimulation. [ 11 – 18 ] However, these options still suffer from limited efficacy, and even very server adverse events (AEs) and complications. Thus, alternative candidates with few AEs are urgently needed to treat this condition.…”

LncRNA expression profiling of BMSCs in osteonecrosis of the femoral head associated with increased adipogenic and decreased osteogenic differentiation

“…The incidence of ONFH has increased over the past decade. It is estimated that 20000 to 30000 new patients are diagnosed with ONFH annually in the United States and 150000 to 200000 new cases in China 3 , 4 . Moreover, the treatment of adult ONFH, with 8.12 million patients in China, remains a challenge to surgeons 5 .…”