Department of Orthopaedic Surgery, Lawrence Ellison Center for Tissue Regeneration and Repair, School of Medicine, University of California , Davis, Davis, California.
Tissue Eng Part B Rev. 2018 Apr;24(2):144-154. doi: 10.1089/ten.TEB.2017.0294. Epub 2017 Nov 17.
Bone and joint formation, maintenance, and regeneration are regulated by both chemical and physical signals. Among the physical signals there is an increasing realization of the role of pulsed electromagnetic fields (PEMF) in the treatment of nonunions of bone fractures. The discovery of the piezoelectric properties of bone by Fukada and Yasuda in 1953 in Japan established the foundation of this field. Pioneering research by Bassett and Brighton and their teams resulted in the approval by the Food and Drug Administration (FDA) of the use of PEMF in the treatment of fracture healing. Although PEMF has potential applications in joint regeneration in osteoarthritis (OA), this evolving field is still in its infancy and offers novel opportunities.
We have systematically reviewed the literature on the influence of PEMF in joints, including articular cartilage, tendons, and ligaments, of publications from 2000 to 2016.
PEMF stimulated chondrocyte proliferation, differentiation, and extracellular matrix synthesis by release of anabolic morphogens such as bone morphogenetic proteins and anti-inflammatory cytokines by adenosine receptors A2 and A3 in both in vitro and in vivo investigations. It is noteworthy that in clinical translational investigations a beneficial effect was observed on improving function in OA knees. However, additional systematic studies on the mechanisms of action of PEMF on joints and tissues therein, articular cartilage, tendons, and ligaments are required.
骨骼和关节的形成、维持和再生受到化学和物理信号的双重调控。在物理信号中，人们越来越认识到脉冲电磁场（PEMF）在治疗骨折不愈合方面的作用。1953 年，日本的 Fukada 和 Yasuda 发现了骨骼的压电特性，为该领域奠定了基础。Bassett 和 Brighton 及其团队的开创性研究导致了食品和药物管理局（FDA）批准将 PEMF 用于治疗骨折愈合。尽管 PEMF 可能在骨关节炎（OA）的关节再生中具有应用潜力，但这一不断发展的领域仍处于起步阶段，提供了新的机会。
我们系统地回顾了 2000 年至 2016 年期间关于 PEMF 在关节（包括关节软骨、肌腱和韧带）中影响的文献。
PEMF 通过释放骨形态发生蛋白和腺苷受体 A2 和 A3 等合成代谢形态发生素以及抗炎细胞因子，刺激软骨细胞增殖、分化和细胞外基质合成，这在体外和体内研究中均得到证实。值得注意的是，在临床转化研究中，观察到 PEMF 对改善 OA 膝关节功能具有有益作用。然而，需要进一步进行关于 PEMF 对关节及其组织（包括关节软骨、肌腱和韧带）作用机制的系统研究。
