Pulsed electromagnetic field treatment enhances healing callus biomechanical properties in an animal model of osteoporotic fracture

Delayed bone healing has been noted in osteoporosis patients and in the ovariectomized (OVX) rat model of estrogen‐depletion osteopenia. Pulsed electromagnetic field (PEMF) devices are clinically approved as an adjunct to cervical fusion surgery in patients at high risk for non‐fusion and for the treatment of fracture non‐unions. These bone growth stimulating devices also accelerate the healing of fresh fracture repair in skeletally mature normal rats but have not been tested for efficacy to accelerate and/or enhance the delayed bone repair process in OVX rats. The current study tested the hypothesis that daily PEMF treatments would improve the fracture healing response in skeletally mature OVX rats. By 6 weeks of healing, PEMF treatments resulted in improved hard callus elastic modulus across fibula fractures normalizing the healing process in OVX rats with respect to this mechanical property. Radiographic evidence showed an improved hard callus bridging across fibula fractures in OVX rats treated with PEMF as compared to sham treatments. These findings provide a scientific rationale for investigating whether PEMF might improve bone‐healing responses in at‐risk osteoporotic patients. Bioelectromagnetics. Bioelectromagnetics. 35:396–405, 2014. © 2014 Wiley Periodicals, Inc.

[1]  S. Khosla,et al.  Estrogen and the skeleton , 2012, Trends in Endocrinology & Metabolism.

[2]  R. Recker,et al.  Pathophysiology of osteoporosis: new mechanistic insights. , 2012, Endocrinology and metabolism clinics of North America.

[3]  M. Bhandari,et al.  When Is a Fracture Healed? Radiographic and Clinical Criteria Revisited , 2010, Journal of orthopaedic trauma.

[4]  G. Lyritis,et al.  The laboratory rat as an animal model for osteoporosis research. , 2008, Comparative medicine.

[5]  M. Costa,et al.  The role of electromagnetic stimulation in the management of established non-union of long bone fractures: what is the evidence? , 2008, Injury.

[6]  D. Marsh,et al.  Effect of osteoporosis on bone mineral density and fracture repair in a rat femoral fracture model , 2008, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[7]  T. Damron,et al.  Ontogeny of Skeletal Maturation in the Juvenile Rat , 2008, Anatomical record.

[8]  L. Qin,et al.  Changes of microstructure and mineralized tissue in the middle and late phase of osteoporotic fracture healing in rats. , 2007, Bone.

[9]  N. Selvamurugan,et al.  Effects of BMP‐2 and pulsed electromagnetic field (PEMF) on rat primary osteoblastic cell proliferation and gene expression , 2007, Journal of Orthopaedic Research.

[10]  R. Buckley,et al.  Fracture healing in osteoporotic fractures: is it really different? A basic science perspective. , 2007, Injury.

[11]  R. Midura,et al.  Decibel Attenuation of Pulsed Electromagnetic Field (PEMF) in Blood and Cortical Bone Determined Experimentally and from the Theory of Ohmic Losses , 2006, Annals of Biomedical Engineering.

[12]  C. Brighton,et al.  Up-regulation of bone morphogenetic proteins in cultured murine bone cells with use of specific electric fields. , 2006, The Journal of bone and joint surgery. American volume.

[13]  Yoshitada Sakai,et al.  Pulsed electromagnetic field treatments enhance the healing of fibular osteotomies , 2005, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[14]  Guang-Feng Zhao,et al.  Osteoporosis influences the middle and late periods of fracture healing in a rat osteoporotic model. , 2005, Chinese journal of traumatology = Zhonghua chuang shang za zhi.

[15]  R. Aspden.  Mechanical testing of bone ex vivo. , 2003, Methods in molecular medicine.

[16]  D. M. Banks,et al.  Age and ovariectomy impair both the normalization of mechanical properties and the accretion of mineral by the fracture callus in rats , 2001, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[17]  W. Jee,et al.  Overview: animal models of osteopenia and osteoporosis. , 2001, Journal of musculoskeletal & neuronal interactions.

[18]  P. Babyn,et al.  Development and duration of radiographic signs of bone healing in children. , 2000, AJR. American journal of roentgenology.

[19]  T. Kubo,et al.  Osteoporosis influences the late period of fracture healing in a rat model prepared by ovariectomy and low calcium diet , 1999, The Journal of Steroid Biochemistry and Molecular Biology.

[20]  J. Kanczler,et al.  Pulsed Electromagnetic Fields Simultaneously Induce Osteogenesis and Upregulate Transcription of Bone Morphogenetic Proteins 2 and 4 in Rat Osteoblastsin Vitro , 1998 .

[21]  M. Brookes,et al.  The effects of pulsed electromagnetism on fresh fracture healing: osteochondral repair in the rat femoral groove. , 1998, Orthopedics.

[22]  J. Kanczler,et al.  Pulsed electromagnetic fields simultaneously induce osteogenesis and upregulate transcription of bone morphogenetic proteins 2 and 4 in rat osteoblasts in vitro. , 1998, Biochemical and biophysical research communications.

[23]  C. R. Howlett,et al.  Fracture Healing in a Rat Osteopenia Model , 1997, Clinical orthopaedics and related research.

[24]  D. Kalu.  The ovariectomized rat model of postmenopausal bone loss. , 1991, Bone and mineral.

[25]  S. Pollack,et al.  Theoretical determination of the current density distributions in human vertebral bodies during electrical stimulation , 1990, IEEE Transactions on Biomedical Engineering.

[26]  C. Rubin,et al.  Prevention of osteoporosis by pulsed electromagnetic fields. , 1989, The Journal of bone and joint surgery. American volume.

[27]  S. Pollack,et al.  Treatment of sciatic denervation disuse osteoporosis in the rat tibia with capacitively coupled electrical stimulation. Dose response and duty cycle. , 1985, The Journal of bone and joint surgery. American volume.

[28]  S. Pollack,et al.  Fracture healing in the rabbit fibula when subjected to various capacitively coupled electrical fields , 1985, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[29]  J. Ryaby,et al.  Treatment of non-union by pulsing electromagnetic field: European multicenter study of 308 cases. , 1985, Reconstruction surgery and traumatology.

[30]  K. Takebe,et al.  Role of the Fibula in Weight‐bearing , 1984, Clinical orthopaedics and related research.

[31]  C. Bassett,et al.  Electromagnetic stimulation of fracture repair. Influence on healing of fresh fractures. , 1978, Acta orthopaedica Belgica.