In VitroEvaluation of the Effects of Electromagnetic Fields used for Bone Healing

Histomorphometric and mechanical analysis of the hydroxyapatite-bone interface after electromagnetic stimulation: an experimental study in rabbits

We investigated the effect of stimulation with a pulsed electromagnetic field on the osseointegration of hydroxyapatite in cortical bone in rabbits. Implants were inserted into femoral cortical bone and were stimulated for six hours per day for three weeks. Electromagnetic stimulation improved osseointegration of hydroxyapatite compared with animals which did not receive this treatment in terms of direct contact with the bone, the maturity of the bone and mechanical fixation. The highest values of maximum push-out force (F(max)) and ultimate shear strength (sigma(u)) were observed in the treated group and differed significantly from those of the control group at three weeks (F(max); p < 0.0001; sigma(u), p < 0.0005).

Biomimetic PMMA-based bone substitutes: a comparative in vitro evaluation of the effects of pulsed electromagnetic field exposure

Pulsed electromagnetic fields (PEMFs) are known to be effective in the stimulation of cultured osteoblasts and in vivo healing of delayed and nonunion fractures. In the present in vitro study the effects of PEMFs on osteoblastic cell cultures (MG63 human osteoblast-like cells) grown in the presence of poly-methylmethacrylate (PMMA) and of a biomimetic bone substitute made of a PMMA matrix added with alfa-tricalcium phosphate (PMMA+alpha-TCP) were evaluated, to assess the biological response at the cell-biomaterial interaction. Cultures were stimulated with PEMFs (75 Hz, 2.3 mT, 1.3-ms pulse duration) 12 h/day for 3 days and evaluations (MTT, ALP, OC, PICP, TGFbeta-1, IL-6) were performed at 3 and 6 days. PMMA had a negative effect on osteoblasts, whereas PMMA+alpha-TCP enhanced production of ALP, PICP, OC and TGFbeta-1, and reduced IL-6 levels. Cells responded positively to PEMF stimulation even when cultured with a poorly biocompatible material, such as PMMA. This effect was more evident in the presence of PMMA+alpha-TCP (further improvement in proliferation and synthetic activity) both at 3 and at 6 days. The properties of PMMA+alpha-TCP look promising, and the present results support the use of PEMFs to improve tissue response to biomaterials implanted as bone substitutes.

The effect of pulsed electromagnetic fields on the osteointegration of hydroxyapatite implants in cancellous bone: a morphologic and microstructural in vivo study

Effects of pulsed electromagnetic fields (PEMFs, 75 Hz. 1.6 mT) were investigated in 12 rabbits after placing hydroxyapatite (HA) implants in their femoral condyles. Six animals were stimulated with PEMFs for three consecutive weeks, 6 h/day, while the remaining animals were sham-treated (Control Group). Rabbits were sacrificed at 3 and 6 weeks (after a 3-week non-stimulation period) for histomorphometric analysis and microhardness testing (at 200, 500, 1,000, 2,000 microm from the implant) around the implants. Histomorphometric analysis did not highlight any significant changes. On the contrary, there were statistically significant differences between the effects produced by PEMFs and Control Groups (F = 149.70, p < 0.0005) on the Affinity Index results, as well as by the experimental time of 6 and 3 weeks (F = 17.12, p = 0.001) on the same results. In PEMF-stimulated animals the microhardness (HV) values measured in trabecular bone at a distance of 200 and 500 microm from the implants, were significantly higher with respect to controls. At 6 weeks, HV values at the bone-implant interface in PEMF-stimulated animals were not significantly different with respect to normal bone, while they remained significantly lower in control animals. Both morphological and structural results demonstrated a positive therapeutic effect of PEMFs in accelerating HA osteointegration in trabecular bone.