J Clin Med. 2019 Nov 20;8(12). pii: E2028. doi: 10.3390/jcm8122028.
Ehnert S1, Schröter S1, Aspera-Werz RH1, Eisler W1, Falldorf K2, Ronniger M2, Nussler AK1.
Author information
1 Siegfried Weller Institute for Trauma Research, Depterment of Trauma and Reconstructive Surgery, BG Unfallklinik Tübingen, Eberhard Karls Universität Tübingen, D-72076 Tübingen, Germany.
2 Sachtleben GmbH, Hamburg, Haus Spectrum am UKE, Martinistraße 64, D-20251 Hamburg, Germany.
Abstract
The finding that alterations in electrical potential play an important role in the mechanical stimulation of the bone provoked hype that noninvasive extremely low frequency pulsed electromagnetic fields (ELF-PEMF) can be used to support healing of bone and osteochondral defects. This resulted in the development of many ELF-PEMF devices for clinical use. Due to the resulting diversity of the ELF-PEMF characteristics regarding treatment regimen, and reported results, exposure to ELF-PEMFs is generally not among the guidelines to treat bone and osteochondral defects. Notwithstanding, here we show that there is strong evidence for ELF-PEMF treatment. We give a short, confined overview of in vitro studies investigating effects of ELF-PEMF treatment on bone cells, highlighting likely mechanisms. Subsequently, we summarize prospective and blinded studies, investigating the effect of ELF-PEMF treatment on acute bone fractures and bone fracture non-unions, osteotomies, spinal fusion, osteoporosis, and osteoarthritis. Although these studies favor the use of ELF-PEMF treatment, they likewise demonstrate the need for more defined and better controlled/monitored treatment modalities. However, to establish indication-oriented treatment regimen, profound knowledge of the underlying mechanisms in the sense of cellular pathways/events triggered is required, highlighting the need for more systematic studies to unravel optimal treatment conditions.
KEYWORDS:
bone cells; bone mineral density; extremely low frequency pulsed electromagnetic fields (ELF-PEMF), bone regeneration; fracture healing; osteoarthritis; osteoporosis; pain; spinal fusion
PMID: 31756999 PMCID: PMC6947624 DOI: 10.3390/jcm8122028