Electrical stimulation for long-bone fracture-healing: A meta-analysis of randomized controlled trials

Journal of Bone and Joint Surgery

Volumn 90, Issue 11, 2008, Pages 2322-2330

  Mollon, Brent ^a   Da Silva, Vitor ^a   Busse, Jason W ^b   Einhorn, Thomas A ^c   Bhandari, Mohit ^b  

^a McMaster University ^*  (Canada)

^b MCMASTER UNIVERSITY   (Canada)

^c BOSTON UNIVERSITY SCHOOL OF MEDICINE   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

BONE DENSITOMETRY; BONE REMODELING; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; ELECTROMAGNETIC FIELD; ELECTROSTIMULATION; FRACTURE HEALING; HUMAN; PATIENT CARE; PRIORITY JOURNAL; PSEUDARTHROSIS; REVIEW; SYSTEMATIC REVIEW; TREATMENT DURATION; TREATMENT OUTCOME;

EID: 55849116660     PISSN: 00219355     EISSN: None     Source Type: Journal    
DOI: 10.2106/JBJS.H.00111     Document Type: Review

References (49)

1. Megas P. Classification of non-union. Injury. 2005;36 Suppl 4:S30-7.
2. Musculoskeletal injuries report: incidence, risk factors and prevention. Rosemont, IL: American Academy of Orthopaedic Surgeons; 2000.
3. Nelson FR, Brighton CT, Ryaby J, Simon BJ, Nielson JH, Lorich DG, Bolander M, Seelig J. Use of physical forces in bone healing. J Am Acad Orthop Surg. 2003;11:344-54.
4. Heckman JD, Sarasohn-Kahn J. The economics of treating tibia fractures. The cost of delayed unions. Bull Hosp Jt Dis. 1997;56:63-72.
5. Einhorn TA. Enhancement of fracture-healing. J Bone Joint Surg Am. 1995;77:940-56.
6. Anglen J. The clinical use of bone stimulators. J South Orthop Assoc. 2003;12:46-54.
7. Karamitros AE, Kalentzos VN, Soucacos PN. Electric stimulation and hyperbaric oxygen therapy in the treatment of nonunions. Injury. 2006;37 Suppl 1:S63-73.
8. Hartshorne E. Monograph. On the causes and treatment of pseudarthrosis and especially of that form of it sometimes called supranumery joint. Am J Med Sci. 1841;1:121-56.
9. Lente RW. Cases of un-united fracture treated by electricity. N Y State J Med. 1850;5:317-9.
10. Fukada E, Yasuda I. On the piezoelectric effect of bone. J Phys Soc Japan. 1957;12:1158-69.
11. Aaron RK, Boyan BD, Ciombor DM, Schwartz Z, Simon BJ. Stimulation of growth factor synthesis by electric and electromagnetic fields. Clin Orthop Relat Res. 2004;419:30-7.
12. Guerkov HH, Lohmann CH, Liu Y, Dean DD, Simon BJ, Heckman JD, Schwartz Z, Boyan BD. Pulsed electromagnetic fields increase growth factor release by nonunion cells. Clin Orthop Relat Res. 2001;384:265-79.
13. Lohmann CH, Schwartz Z, Liu Y, Li Z, Simon BJ, Sylvia VL, Dean DD, Bonewald LF, Donahue HJ, Boyan BD. Pulsed electromagnetic fields affect phenotype and connexin 43 protein expression in MLO-Y4 osteocyte-like cells and ROS 17/2.8 osteoblast-like cells. J Orthop Res. 2003;21:326-34.
14. Ciombor DM, Aaron RK. The role of electrical stimulation in bone repair. Foot Ankle Clin. 2005;10:579-93, vii.
15. Heermeier K, Spanner M, Träger J, Gradinger R, Strauss PG, Kraus W, Schmidt J. Effects of extremely low frequency electromagnetic field (EMF) on collagen type I mRNA expression and extracellular matrix synthesis of human osteoblastic cells. Bioelectromagnetics. 1998;19:222-31.
16. Spadaro JA. Mechanical and electrical interactions in bone remodeling. Bioelectromagnetics. 1997;18:193-202.
17. Haddad JB, Obolensky AG, Shinnick P. The biologic effects and the therapeutic mechanism of action of electric and electromagnetic field stimulation on bone and cartilage: new findings and a review of earlier work. J Altern Complement Med. 2007;13:485-90.
18. Barker AT, Dixon RA, Sharrard WJ, Sutcliffe ML. Pulsed magnetic field therapy for tibial non-union. Interim results of a double-blind trial. Lancet. 1984;1:994-6.
19. Scott G, King JB. A prospective, double-blind trial of electrical capacitive coupling in the treatment of non-union of long bones. J Bone Joint Surg Am. 1994;76:820-6.
20. Betti E, Marchetti S, Cadossi R, Faldini C, Faldini A. Effect of stimulation by low-frequency pulsed electromagnetic fields in subjects with fracture of the femoral neck. In: Bersani F, editor. Electricity and magnetism in biology and medicine. New York: Kluwer Academic/Plenum; 1999. p 853-5.
21. Wahlstrom O. Stimulation of fracture healing with electromagnetic fields of extremely low frequency (EMF of ELF). Clin Orthop Relat Res. 1984;186:293-301.
22. Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, Guyatt GH, Harbour RT, Haugh MC, Henry D, Hill S, Jaeschke R, Leng G, Liberati A, Magrini N, Mason J, Middleton P, Mrukowicz J, O'Connell D, Oxman AD, Phillips B, Schunemann HJ, Edejer TT, Varonen H, Vist GE, Williams JW Jr, Zaza S; GRADE Working Group. Grading quality of evidence and strength of recommendations. BMJ. 2004;328:1490.
23. Fontanesi G, Traina GC, Giancecchi F, Tartaglia I, Rotini R, Virgili B, Cadossi R, Ceccherelli G, Marino AA. Slow healing fractures: can they be prevented? (Results of electrical stimulation in fibular osteotomies in rats and in diaphyseal fractures of the tibia in humans). Ital J Orthop Traumatol. 1986;12:371-85.
24. Borsalino G, Bagnacani M, Bettati E, Fornaciari F, Rocchi R, Uluhogian S, Ceccherelli G, Cadossi R, Traina GC. Electrical stimulation of human femoral intertrochanteric osteotomies. Double-blind study. Clin Orthop Relat Res. 1988;237:256-63.
25. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159-74.
26. Zou GY. One relative risk versus two odds ratios: implications for meta-analyses involving paired and unpaired binary data. Clin Trials. 2007;4:25-31.
27. DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7:177-88.
28. Alderson P, Green S, Higgins J, editors. Cochrane reviewers' handbook 4.2.2. The Cochrane Library. Chichester, UK: John Wiley and Sons; 2004.
29. Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21:1539-58.
30. Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ. 2003;327:557-60.
31. Pieber K, Schuhfried O, Fialka-Moser V. [Pulsed electromagnetic fields (PEMF) - results in evidence based medicine]. Wien Med Wochenschr. 2007;157:34-6. German.
32. Akai M, Hayashi K. Effect of electrical stimulation on musculoskeletal systems; a meta-analysis of controlled clinical trials. Bioelectromagnetics. 2002;23:132-43.
33. Traina GC, Sollazzo V, Massari L. Electrical stimulation of tibial osteotomies: a double blind study. In: Bersani F, editor. Electricity and magnetism in biology and medicine. New York: Kluwer Academic/Plenum; 1999. p 137-8.
34. Simonis RB, Parnell EJ, Ray PS, Peacock JL. Electrical treatment of tibial non-union: a prospective, randomised, double-blind trial. Injury. 2003;34:357-62.
35. Sharrard WJ. A double-blind trial of pulsed electromagnetic fields for delayed union of tibial fractures. J Bone Joint Surg Br. 1990;72:347-55.
36. Poli G, Dal Monte A, Cosco F. Treatment of congenital pseudarthrosis with endomedullary nail and low frequency pulsing electromagnetic fields: a controlled study. Electromagnetic Biology and Medicine. 1985;4:195-209.
37. Mammi GI, Rocchi R, Cadossi R, Massari L, Traina GC. The electrical stimulation of tibial osteotomies. Double-blind study. Clin Orthop Relat Res. 1993;288:246-53.
38. Eyres KS, Saleh M, Kanis JA. Effect of pulsed electromagnetic fields on bone formation and bone loss during limb lengthening. Bone. 1996;18:505-9.
39. Beck BR, Matheson GO, Bergman G, Norling T, Fredericson M, Hoffman AR, Marcus R. Do capacitively coupled electric fields accelerate tibial stress fracture healing? A randomized controlled trial. Am J Sports Med. 2008;36:545-53.
40. Fourie JA, Bowerbank P. Stimulation of bone healing in new fractures of the tibial shaft using interferential currents. Physiother Res Int. 1997;2:255-68.
41. Livesley PJ, Mugglestone A, Whitton J. Electrotherapy and the management of minimally displaced fracture of the neck of the humerus. Injury. 1992;23:323-7.
42. Cheing GL, Wan JW, Kai Lo S. Ice and pulsed electromagnetic field to reduce pain and swelling after distal radius fractures. J Rehabil Med. 2005;37:372-7.
43. O'Connor BT. Pulsed magnetic field therapy for tibial non-union. Lancet. 1984;2:171-2.
44. Bryant D, Havey TC, Roberts R, Guyatt G. How many patients? How many limbs? Analysis of patients or limbs in the orthopaedic literature: a systematic review. J Bone Joint Surg Am. 2006;88:41-5.
45. Walker NA, Denegar CR, Preische J. Low-intensity pulsed ultrasound and pulsed electromagnetic field in the treatment of tibial fractures: a systematic review. J Athl Train. 2007;42:530-5.
46. Griffin XL, Warner F, Costa M. The role of electromagnetic stimulation in the management of established non-union of long bone fractures: what is the evidence? Injury. 2008;39:419-29.
47. Akai M, Kawashima N, Kimura T, Hayashi K. Electrical stimulation as an adjunct to spinal fusion: a meta-analysis of controlled clinical trials. Bioelectromagnetics. 2002;23:496-504.
48. Busse JW, Morton E, Lacchetti C, Guyatt GH, Bhandari M. Current management of tibial shaft fractures: a Canadian survey of orthopaedic trauma surgeons. Acta Orthop. In press.
49. Wachovia Capital Markets, LLC. Equity research: bone growth stimulation 2008 outlook. 2007.