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01-03-2019 | Review

Biophysical stimulation of bone and cartilage: state of the art and future perspectives

Authors: Leo Massari, Franco Benazzo, Francesco Falez, Dario Perugia, Luca Pietrogrande, Stefania Setti, Raffaella Osti, Enrico Vaienti, Carlo Ruosi, Ruggero Cadossi

Published in: International Orthopaedics | Issue 3/2019

Abstract

Introduction

Biophysical stimulation is a non-invasive therapy used in orthopaedic practice to increase and enhance reparative and anabolic activities of tissue.

Methods

A sistematic web-based search for papers was conducted using the following titles: (1) pulsed electromagnetic field (PEMF), capacitively coupled electrical field (CCEF), low intensity pulsed ultrasound system (LIPUS) and biophysical stimulation; (2) bone cells, bone tissue, fracture, non-union, prosthesis and vertebral fracture; and (3) chondrocyte, synoviocytes, joint chondroprotection, arthroscopy and knee arthroplasty.

Results

Pre-clinical studies have shown that the site of interaction of biophysical stimuli is the cell membrane. Its effect on bone tissue is to increase proliferation, synthesis and release of growth factors. On articular cells, it creates a strong A_2A and A₃ adenosine-agonist effect inducing an anti-inflammatory and chondroprotective result. In treated animals, it has been shown that the mineralisation rate of newly formed bone is almost doubled, the progression of the osteoarthritic cartilage degeneration is inhibited and quality of cartilage is preserved. Biophysical stimulation has been used in the clinical setting to promote the healing of fractures and non-unions. It has been successfully used on joint pathologies for its beneficial effect on improving function in early OA and after knee surgery to limit the inflammation of periarticular tissues.

Discussion

The pooled result of the studies in this review revealed the efficacy of biophysical stimulation for bone healing and joint chondroprotection based on proven methodological quality.

Conclusion

The orthopaedic community has played a central role in the development and understanding of the importance of the physical stimuli. Biophysical stimulation requires care and precision in use if it is to ensure the success expected of it by physicians and patients.

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Title: Biophysical stimulation of bone and cartilage: state of the art and future perspectives
Authors: Leo Massari
Franco Benazzo
Francesco Falez
Dario Perugia
Luca Pietrogrande
Stefania Setti
Raffaella Osti
Enrico Vaienti
Carlo Ruosi
Ruggero Cadossi
Publication date: 01-03-2019
Publisher: Springer Berlin Heidelberg
Published in: International Orthopaedics / Issue 3/2019
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI: https://doi.org/10.1007/s00264-018-4274-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Biophysical stimulation of bone and cartilage: state of the art and future perspectives

Abstract

Introduction

Methods

Results

Discussion

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Introduction

Methods

Results

Discussion

Conclusion

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