Farr Jack, Mont Michael A, Garland Douglas, Caldwell Jacques R, Zizic Thomas M
Orthopedic Surgery, Orthopaedics IN, Indiana University Medical Center, Indianapolis, IN, USA.
Surg Technol Int. 2006;15:227-33.
Optimized pulsed electrical stimulation (PES) regulates chondrocyte genes, enhances production of cartilage matrix materials, and inhibits production of matrix catabolic factors.
This prospective, cohort study examined the use of a PES device in treatment of knee osteoarthritis (OA) in patients who had failed non-operative therapy. Primary outcome measures were patient and physician global evaluation, and patient assessment of knee pain.
This study included 288 (95 men, 193 women) patients who used the device from 16 to more than 600 days (mean: 889 hours). Improvement in all efficacy variables (p < 0.001) occurred. A dose-response relationship between effect size and hours of usage was observed as cumulative time increased to more than 750 hours. Improvement in patient or physician global occurred in 59.0% of patients who used it less than 750 hours, and for 73.0% of those who used it more than 750 hours. An economic analysis of a sub-group of patients showed that 45.3% reduced nonsteroidal anti-inflammatory drug (NSAID) use by 50.0% or more.
A highly optimized PES device successfully attenuated knee OA symptoms in patients who had failed non-surgical therapy. Less than 250 hours of therapy provided relief, but improvement increased in a dose-response manner after 750 hours of cumulative use.
优化的脉冲电刺激（PES）可调节软骨细胞基因，增强软骨基质材料的产生，并抑制基质分解代谢因子的产生。
这项前瞻性队列研究考察了PES设备在非手术治疗失败的膝骨关节炎（OA）患者中的应用。主要结局指标为患者和医生的整体评估以及患者对膝关节疼痛的评估。
本研究纳入了288例患者（95例男性，193例女性），他们使用该设备的时间为16天至600多天（平均：889小时）。所有疗效变量均有改善（p<0.001）。随着累计使用时间增加至750小时以上，观察到效应大小与使用小时数之间存在剂量反应关系。使用时间少于750小时的患者中，59.0%的患者或医生整体评估有改善；使用时间超过750小时的患者中，这一比例为73.0%。对一组亚组患者的经济分析表明，45.3%的患者非甾体抗炎药（NSAID）使用量减少了50.0%或更多。
一种高度优化的PES设备成功减轻了非手术治疗失败患者的膝OA症状。少于250小时的治疗即可缓解症状，但累计使用750小时后，改善情况呈剂量反应方式增加。
