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Role of Electromagnetic Stimulation in the Treatment of Osteonecrosis of the Femoral Head in Early Stages

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DOI: 10.4236/jbise.2014.75028    3,325 Downloads   4,321 Views   Citations

ABSTRACT

Osteonecrosis of the femoral head is a disorder that leads to collapse and osteoarthritis in young patients. This study examines the effectiveness of pulsed electromagnetic fields [PEMF] in the treatment of osteonecrosis of the head in precollapse bone stages. A retrospective evaluation was done of 51 patients including 70 hips with symptomatic osteonecrosis of the hip treated with pulsed electromagnetic fields. Criteria for inclusion in the study group were evidence of osteonecrosis and absence of collapse of the femoral head. The average follow-up was 26 months (range, 18 - 90). Etiologies included idiopathic (40 cases), steroid use (26) and alcohol (4). To demonstrate the existence of osteonecrosis and its evolution, magnetic resonance imaging [MRI] and plain radiography techniques were used. Results: Procedures were radiological success in 80% of cases, and no progression to collapse in 88.57% of hips. Eight of the 70 hips had radiographic progression to collapse. This study suggests that selected PEMF reduce the incidence of progression of osteonecrosis of femoral head in early stage.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Cebrián, J. , Milano, G. , Francés, A. , Lopiz, Y. , Marco, F. and López-Durán, L. (2014) Role of Electromagnetic Stimulation in the Treatment of Osteonecrosis of the Femoral Head in Early Stages. Journal of Biomedical Science and Engineering, 7, 252-257. doi: 10.4236/jbise.2014.75028.

References

[1] Koo, K.-H., Kim, R. and Ko, G.-H. (1995) Preventing Collapse in Early Osteonecrosis of the Femoral Head: A Randomized Clinical Trial of Core Decompression. Journal of Bone and Joint Surgery, 77, 8.
[2] Mont, M.A., Carbone, J.J. and Fairbank, A.C. (1996) Core Decompression versus Nonoperative Management for Osteonecrosis of the Hip. Clinical Orthopaedics and Related Research, 324, 169-178.
http://dx.doi.org/10.1097/00003086-199603000-00020
[3] Mont, M., Jones, L., Seyler, T. and Marulanda, G. (2007) New Treatment Approaches for Osteonecrosis of the Femoral Head: An Overview. In Adult Reconstruction Hip. AAOS Instructional Course Lectures, 56, 221-233.
[4] Carsi, B., Gimeno, M., López-Oliva, F. and López-Durán, L. (1996) Utilidad de los campos electromagnéticos en el tratamiento de la Necrosis avascular de cadera: Estudio prospectivo de 30 casos. Revista Clínica Española, 196, 67-74.
[5] Song, W.S., Yoo, J.J., Kim, Y.M. and Kim, H.J. (2007) Results of Multiple Drilling Compared with Those of Conventional Methods of Core Decompression. Clinical Orthopaedics and Related Research, 454, 139-146.
http://dx.doi.org/10.1097/01.blo.0000229342.96103.73
[6] Mont, M.A., Ragland, P.S. and Etienne, G. (2004) Core Decompression of the Femoral Head for Osteonecrosis Using Percutaneous Multiple Small Diameter Drilling. Clinical Orthopaedics and Related Research, 429, 131-138.
http://dx.doi.org/10.1097/01.blo.0000150128.57777.8e
[7] Soucacos, P.N., Beris, A.E., Malizos, K., Koropilias, A., Zalavras, H. and Dailiana, Z. (2001) Treatment of Avascular Necrosis of the Femoral Head with Vascularized Fibular Transplant. Clinical Orthopaedics and Related Research, 386, 120-130.
http://dx.doi.org/10.1097/00003086-200105000-00016
[8] Hasegawa, Y., Iwata, H., Torii, S., Iwase, T., Kawamoto, K. and Iwasada, S. (1997) Vascularized Pedicle Bone-Grafting for Nontraumatic Avascular Necrosis of the Femoral Head: A 5- to 11-Year Follow-Up. Archives of Orthopaedic and Trauma Surgery, 116, 251-258.
http://dx.doi.org/10.1007/BF00390047
[9] ARCO (Association Research Circulation Osseous) (1992) Committee on Terminology and Classification. ARCO News, 4, 41-46.
[10] Aaron, R., Lennox, D., Bunce, G. and Ebert, T. (1989) The Conservative Treatment of Osteonecrosis of the Femoral Head. A Comparison of Core Decompression and Pulsing Electromagnetic Fields. Clinical Orthopaedics and Related Research, 249, 209-218.
[11] Shimizu, K., Moriya, H., Akita, T., et al. (1994) Prediction of Collapse with Magnetic Resonance Imaging of Avascular Necrosis of the Femoral Head. Journal of Bone and Joint Surgery, 76, 215-223.
[12] Ohzono, K., Saito, M., Takaoka, K., Ono, K., Saito, S., Nishina, T., et al. (1991) Natural History of Nontraumatic Avascular Necrosis of the Femoral Head. Journal of Bone and Joint Surgery, 73, 68-72.
[13] Aiello, M.R. and Utica, N.Y. (2006) Imaging in Avascular Necrosis of the Femoral Head [Internet]. Utica, NY.
http://emedicine.medscape.com/article/386808
[14] Jones, L. and Hungerford, D. (2007) The Pathogenesis of Osteonecrosis. In Adult Reconstruction Hip. AAOS Instructional Course Lectures, 56, 179-196.
[15] Adair, R.K. (1991) Biological Effects on the Cellular Level of Electric Field Pulses. Health Physics, 61, 395-399.
http://dx.doi.org/10.1097/00004032-199109000-00009
[16] Cooper, M.S. (1995) Membrane Potential Perturbations Induced in Tissue Cells by Pulsed Electric Fields. Bioelectromagnetic, 16, 255-262.
http://dx.doi.org/10.1002/bem.2250160408
[17] Pan, X., Xiao, D., Zhang, X., Huang, Y. and Lin, B. (2009) Study of Rotating Permanent Magnetic Field to Treat Steroid-Induced Osteonecrosis of Femoral Head. International Orthopaedics, 33, 617-623.
http://dx.doi.org/10.1007/s00264-007-0506-7
[18] Massari, L., Fini, M., Ruggero, C., Stefania, S. and Traina, G. (2009) Biophysical Stimulation in Osteonecrosis of the Femoral Head. Indian Journal of Orthopaedics, 43, 17-21.
http://dx.doi.org/10.4103/0019-5413.45319
[19] Ongaro, A., Pellati, A., Masieri, F.F., Caruso, A., Setti, S., Cadossi, R., Biscione, R., Massari, L., Fini, M. and De Mattei, M. (2011) Chondroprotective Effects of Pulsed Electromagnetic Fields on Human Cartilage Explants. Bioelectromagnetics, 32, 543-551.
http://dx.doi.org/10.1002/bem.20663
[20] Brighton, C., Shaman, P. and Heppenstall, B. (1995) Tibial Non-Union Treated with Direct Current; Capacitative Coupling; or Bone Graft. Clinical Orthopaedics and Related Research, 321, 223-227.
[21] Scott, G. and King, J.B. (1994) A Prospective; Double-Blind Trial of Electrical Capacitative Coupling in the Treatment of Non-Union of Long Bone. Journal of Bone and Joint Surgery, 76A, 820-825.
[22] Aaron, R.K. and Stemberg, M.E. (1991) Electrical Stimulation of Osteonecrosis of the Femoral Head. Seminars in Arthroplasty, 12, 214-221.
[23] Basset, C.A., Scihnk-Ascani, M. and Lewis, S.M. (1989) Effects of Pulsed Electromagnetic Fields on Steinberg Ratings of Femoral Head Osteonecrosis. Clinical Orthopaedics and Related Research, 246, 172-185.
[24] Ozhono, K., Saito, M., Sugano, N., et al. (1992) The Fate of Nontraumatic Avascular Necrosis of the Femoral Head. A Radiological Classification to Formulate Prognosis. Clinical Orthopaedics and Related Research, 277, 73-78.

  
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