PEMF and Knee Problems

PEMF and Knee Problems(abstract from our NTA members only material)

Abstracts of scientific studies on the use of PEMF with Knee Problems:

Effectiveness of pulsed electromagnetic field (PEMF) therapy in the management of osteoarthritis of the knee: a meta-analysis of randomized controlled trials
OBJECTIVE: To assess the effectiveness of pulsed electromagnetic fields compared with placebo in the management of osteoarthritis of the knee. DATA SOURCES: A systematic review of PubMed, EMBASE, and the Cochrane Controlled Trials Register. METHODS: Randomized, controlled trials reporting on the blinded comparison of pulsed electromagnetic fields with placebo were included. Validity was tested according to the Jadad Scale. Studies were pooled using fixed-effects and random-effects models after exclusion of publication bias and assessment of heterogeneity. Sensitivity analyses and meta-regression were performed to test the stability of our findings. RESULTS: Nine studies, including 483 patients, were pooled. No significant difference could be shown for pain (weighted mean difference 0.2 patients; 95% confidence interval (CI): -0.4 to 0.8) or stiffness (weighted mean difference 0.3; 95% CI: -0.3 to 0.9). There was a significant effect on activities of daily living (weighted mean difference 0.8; 95% CI 0.2-1.4, p = 0.014) and scores (standardized mean difference 0.4; 95% CI: 0.05-0.8, p = 0.029). We saw only statistically insignificant differences between studies with different treatment protocols.

CONCLUSION: Pulsed electromagnetic fields improve clinical scores and function in patients with osteoarthritis of the knee and should be considered as adjuvant therapies in their management. There is still equipoise of evidence for an effect on pain in the current literature.

  • Author: Vavken, P. and Arrich, F. and Schuhfried, O. and Dorotka, R.
  • Year: 2009
  • Link: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=19479151
  • Comment:Vavken, Patrick Arrich, Ferdi Schuhfried, Othmar Dorotka, Ronald Comparative Study Meta-Analysis Review Sweden Journal of rehabilitation medicine : official journal of the UEMS European Board of Physical and Rehabilitation Medicine J Rehabil Med. 2009 May;41(6):406-11.
  • Address: Department of Orthopedic Surgery, Children’s Hospital Boston, 300 Longwood Avenue, Enders 1016, Boston, MA 02115, USA. Patrick.vavken@childrens.harvard.edu
  • Booktitle: J Rehabil Med

_____________________________________________________________________

Effects of pulsed electromagnetic fields (PEMF) on patients’ recovery after arthroscopic surgery: prospective, randomized and double-blind study
Severe joint inflammation following trauma, arthroscopic surgery or infection can damage articular cartilage, thus every effort should be made to protect cartilage from the catabolic effects of pro-inflammatory cytokines and stimulate cartilage anabolic activities. Previous pre-clinical studies have shown that pulsed electromagnetic fields (PEMFs) can protect articular cartilage from the catabolic effects of pro-inflammatory cytokines, and prevent its degeneration, finally resulting in chondroprotection.

These findings provide the rational to support the study of the effect of PEMFs in humans after arthroscopic surgery. The purpose of this pilot, randomized, prospective and double-blind study was to evaluate the effects of PEMFs in patients undergoing arthroscopic treatment of knee cartilage. Patients with knee pain were recruited and treated by arthroscopy with chondroabrasion and/or perforations and/or radiofrequencies. They were randomized into two groups: a control group (magnetic field at 0.05 mT) and an active group (magnetic field of 1.5 mT). All patients were instructed to use PEMFs for 90 days, 6 h per day. The patients were evaluated by the Knee injury and Osteoarthritis Outcome Score (KOOS) test before arthroscopy, and after 45 and 90 days. The use of non-steroidal anti-inflammatory drugs (NSAIDs) to control pain was also recorded. Patients were interviewed for the long-term outcome 3 years after arthroscopic surgery. Thirty-one patients completed the treatment. KOOS values at 45 and 90 days were higher in the active group and the difference was significant at 90 days (P < 0.05).

The percentage of patients who used NSAIDs was 26% in the active group and 75% in the control group (P = 0.015). At 3 years follow-up, the number of patients who completely recovered was higher in the active group compared to the control group (P < 0.05). Treatment aided patient recovery after arthroscopic surgery, reduced the use of NSAIDs, and also had a positive long-term effect.

  • Author: Zorzi, C. and Dall’Oca, C. and Cadossi, R. and Setti, S.
  • Year: 2007
  • Link: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17333120
  • Comment:Zorzi, C Dall’Oca, C Cadossi, R Setti, S Randomized Controlled Trial Germany Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA Knee Surg Sports Traumatol Arthrosc. 2007 Jul;15(7):830-4. Epub 2007 Feb 28.
  • Address: “Sacro Cuore Don Calabria” Hospital, Via don A. Sempreboni 5, 37024 Negrar (Vr), Italy.
  • Booktitle: Knee Surg Sports Traumatol Arthroscopy