Treatment of nonunion using pulsed electromagnetic fields: a retrospective follow-up study.
Pulsed electromagnetic fields (PEMF) are a useful means of treating cases of fracture nonunion. In 67.7% of nonunions with a disability time of at least 24 months, complete consolidation was obtained. This success rate is increased to 76.6% if we exclude nonunion, that presented contraindications for treatment with PEMF. The disability time had no effect on the success rate. Lesions of the humerus and atrophic nonunion had an unfavorable prognosis. Meskens M. et.al. Dep. Orthopedic Surgery, University Hospital, Pellenberg, Belgium. Acta Orthop Belg
Effects of pulsed electromagnetic fields on Steinberg ratings of femoral head osteonecrosis.
95 Patients with femoral head osteonecrosis met the protocol for treatment of 118 hips with selected pulsed electromagnetic fields (PEMFs). Etiologies included trauma (17), alcohol (9), steroid use (46), sickle cell disease (2), and idiopathy (44). The average age was 38 years, and the average follow-up period since the onset of symptoms was 5.3 years. PEMF treatment had been instituted an average of 4.1 years earlier. By the Steinberg quantitative staging method of roentgenographic analysis, none of the 15 hips in Stages 0-III showed progression, and grading improved in nine of 15. Eighteen of 79 hips (23%) with Stage IV lesions progressed and none improved. In the Stage V category, one of 21 hips (5%) worsened and none improved. Three Stage VI lesions were unchanged. The overall rate of quantified progression for the 118 hips, 87% of which had collapse present when entering the program, was 16%. This value represents a reversal of the percentage of progression reported recently by other investigators using conservative and selected surgical methods. PEMF patients also have experienced long-term improvements in symptoms and signs, together with a reduction in the need for early joint arthroplasty. Bassett C. et.al. Orthopaedic Hospital, Riverdale, NY Clin Orthop
Stimulation of experimental endochondral ossification by low-energy pulsing electromagnetic fields.
Pulsed electromagnetic fields (PEMFs) of certain configuration have been shown to be effective clinically in promoting the healing of fracture nonunions and are believed to enhance calcification of extracellular matrix. In vitro studies have suggested that PEMFs may also have the effect of modifying the extracellular matrix by promoting the synthesis of matrix molecules. This study examines the effect of one PEMF upon the extracellular matrix and calcification of endochondral ossification in vivo. The synthesis of cartilage molecules is enhanced by PEMF, and subsequent endochondral calcification is stimulated. Histomorphometric studies indicate that the maturation of bone trabeculae is also promoted by PEMF stimulation. These results indicate that a specific PEMF can change the composition of cartilage extracellular matrix in vivo and raises the possibility that the effects on other processes of endochondral ossification (e.g., fracture healing and growth plates) may occur through a similar mechanism. Aaron R. et.al. Dep. Biochemistry and Biophysics, University of Rhode Island J Bone Miner Res
Role of pulsed electromagnetic fields in recalcitrant non-unions.
Twenty-nine patients of recalcitrant nonunion of long bones were treated by pulsed electromagnetic fields in an attempt to bring about osteogenesis. The pulse used was rectangular, equal mark space wave in the astable, continuous mode operating at a frequency of 40 Hertz. The success rate was 82.5%. The result was not dependent on the age, sex, time of nonunion or the presence of infection. However, the results were uniformly poor when infection and fracture instability were coexistent in the same patient. Delima DF, Tanna DD J Postgrad Med
In vitro low frequency electromagnetic field effect on fast axonal transport.
The objective of this study was to evaluate the effects of a low frequency electromagnetic field on fast axonal transport for future neuroprosthetic applications. Changes in speeds and densities of retrograde fast organelle transport in rat sciatic nerve preparations were measured in vitro upon exposure to 15 and 50 Hz pulsed magnetic fields with peak intensities of 4.4 and 8.8 mT. Maximum current density of the induced eddy current was calculated to be about 40 microA/cm2. Video enhanced differential interference contrast microscopy was used to record axons supporting active organelle transport. Strong effects were observed in myelinated axons (cessation of transport in up to 10 min). Such effects may eventually be used as part of a neuroprosthesis to noninvasively modify or couple to various parts of the nervous system. Zborowski M. et.al. Dep. Artificial Organs, Cleveland Clinic Found. ASAIO Trans
Effects of pulsed extremely-low-frequency magnetic fields on skin wounds in the rat.
Rats with skin-wounds surgically created on their backs were exposed immediately after surgery and every 12 h thereafter to pulsed, extremely-low-frequency magnetic fields. The shape of the pulse was a positive triangle (50 Hz, 8 mT peak). The rate of healing of skin wounds was evaluated macroscopically and by light and electron microscopy at 6, 12, 21, and 42 days after the operation. A significant increase in the rate of wound contraction was found in rats treated with magnetic fields. Forty-two days after surgery all treated animals show fully closed wounds, while control rats at the same time intervals still lacked a final 6% of the wound surface to be covered. Treated rats showed earlier cellular organization, collagen formation and maturation, and a very early appearance of newly formed vascular network. Ottani V. et.al. Istituto di Anatomia, Bologna, Italy. Bioelectromagnetics
Treatment of delayed union and nonunion of the tibia by pulsed electromagnetic
fields. A retrospective follow-up.
The results of a clinical follow-up of 57 tibial lesions treated with pulsed electromagnetic fields at least six months after the primary lesion occurred proved that this noninvasive method can be a valuable alternative to other commonly accepted modes of therapy. The overall success rate was 75% but could be improved to 81% when the proper indications were met. Meskens M. et.al. Dep. Orthopaedics, University Hospital, Pellenberg Bull Hosp Jt Dis Orthop Inst
Enhanced responsiveness to parathyroid hormone and induction of functional differentiation of cultured rabbit costal chondrocytes by a pulsed electromagnetic field.
Pulsed electromagnetic fields promote healing of delayed united and ununited fractures by triggering a series of events in fibrocartilage. We examined the effects of a pulsed electromagnetic field (recurrent bursts, 15.4 Hz, of shorter pulses of an average of 2 gauss) on rabbit costal chondrocytes in culture. A pulsed electromagnetic field slightly reduced the intracellular cyclic adenosine 3',5'-monophosphate (cAMP) level in the culture. However, it significantly enhanced cAMP accumulation in response to parathyroid hormone (PTH) to 140% of that induced by PTH in its absence, while it did not affect cAMP accumulation in response to prostaglandin E1 or prostaglandin I2. The effect on camp accumulation in response to PTH became evident after exposure of the cultures to the pulsed electromagnetic field for 48 h, and was dependent upon the field strength. cAMP accumulation in response to PTH is followed by induction of ornithine decarboxylase, a good marker of differentiated chondrocytes, after PTH treatment for 4 h. Consistent with the enhanced cAMP accumulation, ornithine decarboxylase activity induced by PTH was also increased by the pulsed electromagnetic field to 170% of that in cells not exposed to a pulsed electromagnetic field. Furthermore, stimulation of glycosaminoglycan synthesis, a differentiated phenotype, in response to PTH was significantly enhanced by a pulsed electromagnetic field. Thus, a pulsed electromagnetic field enhanced a series of events in rabbit costal chondrocytes in response to PTH. These findings show that exposure of chondrocytes to a pulsed electromagnetic field resulted in functional differentiation of the cells. Hiraki Y. et.al. Dep. Biochemistry and Calcified-Tissue Metabolism, Faculty of Dentistry, Osaka University, Japan. Biochim Biophys Acta
Impulse magnetic-field therapy for erectile dysfunction: a double-blind, placebo-controlled study.
This double-blind, placebo-controlled study assessed the efficacy of 3 weeks of pulsing magnetic-field therapy for erectile dysfunction (ED). In the active-treatment group, all efficacy endpoints were significantly improved at study end (P < or = .01), with 80% reporting increases in intensity and duration of erection, frequency of genital warmth, and general well-being. Only 30% of the placebo group noted some improvement in their sexual activity; 70% had no change. No side effects were reported. Pelka R. Et.al. Universitat der Bundeswehr Munchen, Neubiberg/Munich, Germany.
Comparison of electromagnetic field stimulation on the healing of small and large intestinal anastomoses.
Magnetic fields have been shown to affect biologic processes. Accordingly, an experimental study was designed to investigate the effect of electromagnetic field therapy on intestinal healing and to compare small and large intestinal anastomoses. Conclusions: Electromagnetic field stimulation provided a significant gain in anastomotic healing in both small and large intestine. The study demonstrated a significant increase in both biochemical and mechanical parameters. Nayci A. et.al. Cakmak M, Aksoyek S, Renda N, Yucesan S. Department of Pediatric Surgery, Mersin University Medical Faculty, Turkey.
