Additional effect of pulsed electromagnetic field therapy on knee osteoarthritis treatment: a randomized, placebo-controlled study

The aim of this study was to evaluate if pulsed electromagnetic field therapy (PEMF) has additional effect on the classical physical treatment of knee osteoarthritis (OA) composed of hot pack, therapeutic ultrasound, and terminal isometric exercises. Forty patients (29 women and 11 men), ages 44 to 78 (mean age was 61.3 ± 7.8 years) were included in our study. Patients with knee osteoarthritis [Kellgren–Lawrence criteria grade 2 and above and an average pain intensity of 40 or more on a 100-mm visual analog scale (VAS)] recruited from outpatient physical medicine and rehabilitation clinic were randomly assigned to receive PEMF or sham PEMF treatment in addition to their physical therapy. Both the PEMF and sham PEMF treatments being evaluated were 55 min/session, five sessions per week for 2 weeks. Each session comprise 20-min hot pack, 5-min therapeutic ultrasound, and 30-min PEMF or sham PEMF treatment applied to the knee of the patients. Patients were evaluated by the Western Ontario and McMasters Universities Osteoarthritis (WOMAC) Index and VAS at the baseline and at the end of treatment. Both PEMF and sham PEMF treatment groups showed statistically significant improvement in WOMAC pain and functional scores at the end of treatment (p < 0.001 in both groups). There were no statistically significant differences between groups in WOMAC pain, stiffness, and physical function scores after treatment (p = 0.906, p = 0.855, p = 0.809, respectively). There was neither difference in concomitant used acetaminophen dose in both groups (p = 0.289). The results of this study show that PEMF does not have additional effect on the classical physical treatment in reducing symptoms of knee OA.

[1]  J. S. Stillman The treatment of osteoarthritis. , 1954, The Medical annals of the District of Columbia.

[2]  L. Fielding,et al.  A double-blind trial of the clinical effects of pulsed electromagnetic fields in osteoarthritis. , 1993, The Journal of rheumatology.

[3]  D. Trock,et al.  The effect of pulsed electromagnetic fields in the treatment of osteoarthritis of the knee and cervical spine. Report of randomized, double blind, placebo controlled trials. , 1994, The Journal of rheumatology.

[4]  D. Hungerford,et al.  The treatment of osteoarthritis of the knee with pulsed electrical stimulation. , 1995, The Journal of rheumatology.

[5]  H. Liu,et al.  Pulsed electromagnetic fields influence hyaline cartilage extracellular matrix composition without affecting molecular structure. , 1996, Osteoarthritis and cartilage.

[6]  R. Aaron,et al.  Acceleration of experimental endochondral ossification by biophysical stimulation of the progenitor cell pool , 1996, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[7]  P. Lees,et al.  Pulsed electromagnetic fields preserve proteoglycan composition of extracellular matrix in embryonic chick sternal cartilage. , 1997, Biochimica et biophysica acta.

[8]  F. Pezzetti,et al.  Effects of Pulsed Electromagnetic Fields on Human Chondrocytes: An In Vitro Study , 1999, Calcified Tissue International.

[9]  M. Snaith,et al.  Generic and condition-specific outcome measures for people with osteoarthritis of the knee. , 1999, Rheumatology.

[10]  D. Trock Electromagnetic fields and magnets. Investigational treatment for musculoskeletal disorders. , 2000, Rheumatic diseases clinics of North America.

[11]  D. Scott,et al.  Magnetic Pulse Treatment for Knee Osteoarthritis: A Randomised, Double-Blind, Placebo-Controlled Study , 2001, Current medical research and opinion.

[12]  F. Pezzetti,et al.  Effects of Pulsed Electromagnetic Fields on Human Articular Chondrocyte Proliferation , 2001, Connective tissue research.

[13]  B. Caterson,et al.  Low frequency EMF regulates chondrocyte differentiation and expression of matrix proteins , 2002, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[14]  P. Diniz,et al.  Nitric oxide mediates the effects of pulsed electromagnetic field stimulation on the osteoblast proliferation and differentiation. , 2002, Nitric oxide : biology and chemistry.

[15]  L. Sharma Nonpharmacologic management of osteoarthritis. , 2002, Current opinion in rheumatology.

[16]  R. Aaron,et al.  Modification of osteoarthritis by pulsed electromagnetic field--a morphological study. , 2003, Osteoarthritis and cartilage.

[17]  D. Gemmati,et al.  Effects of Electromagnetic Fields on Proteoglycan Metabolism of Bovine Articular Cartilage Explants , 2003, Connective tissue research.

[18]  R. Altman,et al.  Use of a permanent magnetic field to inhibit the development of canine osteoarthritis , 2004, Bioelectromagnetics.

[19]  Deborah McK Ciombor,et al.  Stimulation of growth factor synthesis by electric and electromagnetic fields. , 2004, Clinical orthopaedics and related research.

[20]  S. Hepguler,et al.  Translation and validation of the Turkish version of the arthritis impact measurement scales 2 in patients with knee osteoarthritis. , 2005, The Journal of rheumatology.

[21]  E. Fallentin,et al.  Treatment of knee osteoarthritis with pulsed electromagnetic fields: a randomized, double-blind, placebo-controlled study. , 2005, Osteoarthritis and cartilage.

[22]  A. Daşkapan,et al.  Acceptability, reliability, validity and responsiveness of the Turkish version of WOMAC osteoarthritis index. , 2005, Osteoarthritis and cartilage.

[23]  R. Giardino,et al.  Pulsed electromagnetic fields reduce knee osteoarthritic lesion progression in the aged Dunkin Hartley guinea pig , 2005, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[24]  M. Callaghan,et al.  Pulsed electromagnetic energy treatment offers no clinical benefit in reducing the pain of knee osteoarthritis: a systematic review , 2006, BMC musculoskeletal disorders.

[25]  A. Nicolini,et al.  Effect of pulsed electromagnetic field stimulation on knee cartilage, subchondral and epyphiseal trabecular bone of aged Dunkin Hartley guinea pigs. , 2008, Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie.

[26]  D. Evcik,et al.  The effects of pulsed electromagnetic fields in the treatment of knee osteoarthritis: a randomized, placebo-controlled trial , 2009, Rheumatology International.