Use of Pulsed Electromagnetic Fields in Treatment of Loosened Cemented Hip Prostheses

Kennedy, William F.; Roberts, Chris G.; Zuege, Robert C.; Dicus, William T

doi:10.1097/00003086-199301000-00029

Cited by 25 publications

(14 citation statements)

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“…Although the vast majority of electrical stimulation usage in orthopaedics has centered around fracture healing applications, several attempts have been made to improve the success of total joint replacements (TJR). Ten year total hip arthroplasty (THA) follow‐up studies have reported symptomatic loosening which require revision in 1.2–12% of patients for the acetabulum and between 3 and 20% for the femoral component 91. It has also been well documented that bone loss as large as 14% may occur in the first 3 months following THA 92.…”

Section: Application Of Bioelectricity In Orthopaedicsmentioning

confidence: 99%

“…Dallari et al92 used a single voltage pulsed at 75 Hz, with each burst lasting 1.3 ms and a magnetic field 2 ± 0.2 mT whereas Steinberg95 used a 15 Hz pulsing rate with each burst containing 32 pulses inducing a current of 5–20 μA/cm 2 . The inconsistencies in PEMF treatment and dosage have lead many researchers to conclude that electrical stimulation may be useful for delaying the time when a THA may be necessary, but will not improve the longevity of the TJR 91…”

Section: Application Of Bioelectricity In Orthopaedicsmentioning

confidence: 99%

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Bone bioelectricity: What have we learned in the past 160 years?

Isaacson

Bloebaum

2010

J Biomedical Materials Res

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The direct relationship between bone strain and electric fields has spurred continual interest in the field of bioelectricity over the past 160 years. It has been reported that stress-generated potentials alter cell proliferation and extracellular matrix secretion. The observation that endogenous electrical signals facilitate osteoinduction has lead to high production of electrical stimulation devices to fix bone defects. Despite the reported 100,000 nonunions healed as of 1990 with electrical stimulation, skepticism due to lack of homogeneity with trial design and dosage still exists within the scientific community. It is the purpose of this review to assess the bioelectric phenomenon of bone as it applies to piezoelectricity, fracture healing, and overall changes in bone metabolism which occur with controlled electrical stimulation.

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Section: Application Of Bioelectricity In Orthopaedicsmentioning

confidence: 99%

Section: Application Of Bioelectricity In Orthopaedicsmentioning

confidence: 99%

Bone bioelectricity: What have we learned in the past 160 years?

Isaacson

Bloebaum

2010

J Biomedical Materials Res

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“…(Tables 3, 4 and 5) There were a few problems in the studies that set their outcome as the completion time of bone union or wound healing. However, even when there was a positive effect at 6 months, as in the prevention of the loosening of an arti®cial joint [Kennedy et al, 1993], the result had no clinical relevance when its clinical ®nding was aggravated 14 months or 3 years later. In cases when each datum itself was a quantitative one, there were still problems, such as inability to combine the degrees of knee extension lag, hospital stay [Gotlin et al, 1994], and the knee pain scores [Zizic et al,1995].…”

Section: Quality Assessmentmentioning

confidence: 99%

Effect of electrical stimulation on musculoskeletal systems; A meta‐analysis of controlled clinical trials

Akai

Hayashi

2002

Bioelectromagnetics

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This study was a meta-analysis to examine whether electrical stimulation has specific effects in the healing of musculoskeletal repair process and in the diminution of symptoms with bone and joint disorders. Using MEDLINE (1966-1999) and EMBASE (1985-1999) a search for articles was carried out with four medical subject headings. Data were extracted from all the accessed articles and additionally collected from appropriate journal lists. A total of 20 randomized controlled trials on bones was identified which assessed healing of fractures, bone graft, and other conditions; and 29 randomized controlled trials on soft tissues and joints were also found, dealing with healing of skin wounds or dermal ulcers, soft tissue injury, and other conditions. Using criteria through which the quality of studies was assessed, the content of the articles was reorganized into a tabular form. The majority of the identified articles reported positive findings, but all the trials showed methodological flaws to some extent. Because of heterogeneity of the studies and the various outcome measurements, pooling of only part of the data was performed. The combined results of 12 trials on bones and 16 trials on soft tissues, the cases in which major endpoints were mainly union or healing rate, revealed statistically significant effects. The studies in this review had some methodological limitations, and the selected pooled trials do not constitute acceptable proof that electrical stimulation has specific effects on health. However, one cannot ignore the statistically significant positive findings reported in the trials, from which extracted data were able to be combined.

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“…Although this heating effect is small, some enzymes are exquisitely sensitive to small variations in temperature [54]. It was reported that 0.24 W/cm 2 pulsed shortwave diathermy was safe for human with titanium implants [28,55], and 0.5 W/cm 2 continuous microwave could produce thermal effect on fracture rehabilitation in rabbit [15,16]. In the present study, the effective treatment area of the applicator we used was 138.9 cm 2 and the dose of continuous microwave was 0.18 W/cm 2 , which derived from a randomized clinical trial of microwave stimulation of bone healing we did previously.…”

Section: Discussionmentioning

confidence: 99%

Effects of Low-Dose Microwave on Healing of Fractures with Titanium Alloy Internal Fixation: An Experimental Study in a Rabbit Model

Zhang

et al. 2013

PLoS ONE

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BackgroundMicrowave is a method for improving fracture repair. However, one of the contraindications for microwave treatment listed in the literature is surgically implanted metal plates in the treatment field. The reason is that the reflection of electromagnetic waves and the eddy current stimulated by microwave would increase the temperature of magnetic implants and cause heat damage in tissues. Comparing with traditional medical stainless steel, titanium alloy is a kind of medical implants with low magnetic permeability and electric conductivity. But the effects of microwave treatment on fracture with titanium alloy internal fixation in vivo were not reported. The aim of this article was to evaluate the security and effects of microwave on healing of a fracture with titanium alloy internal fixation.MethodsTitanium alloy internal fixation systems were implanted in New Zealand rabbits with a 3.0 mm bone defect in the middle of femur. We applied a 30-day microwave treatment (2,450MHz, 25W, 10 min per day) to the fracture 3 days after operation. Temperature changes of muscle tissues around implants were measured during the irradiation. Normalized radiographic density of the fracture gap was measured on the 10th day and 30th day of the microwave treatment. All of the animals were killed after 10 and 30 days microwave treatment with histologic and histomorphometric examinations performed on the harvested tissues.FindingsThe temperatures did not increase significantly in animals with titanium alloy implants. The security of microwave treatment was also supported by histology of muscles, nerve and bone around the implants. Radiographic assessment, histologic and histomorphometric examinations revealed significant improvement in the healing bone.ConclusionOur results suggest that, in the healing of fracture with titanium alloy internal fixation, a low dose of microwave treatment may be a promising method.

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Use of Pulsed Electromagnetic Fields in Treatment of Loosened Cemented Hip Prostheses

Cited by 25 publications

References 0 publications

Bone bioelectricity: What have we learned in the past 160 years?

Bone bioelectricity: What have we learned in the past 160 years?

Effect of electrical stimulation on musculoskeletal systems; A meta‐analysis of controlled clinical trials

Effects of Low-Dose Microwave on Healing of Fractures with Titanium Alloy Internal Fixation: An Experimental Study in a Rabbit Model

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