Murray Hallie B, Pethica Brian A
EBI, LLC (a Zimmer Biomet company), Parsippany, NJ, USA,
Department of Chemical and Biological Engineering, Princeton University, Princeton, NJ, USA.
Orthop Res Rev. 2016 Dec 1;8:67-72. doi: 10.2147/ORR.S113756. eCollection 2016.
During normal fracture repair, healing occurs within a few months. However, for a minority of patients, the processes of bone repair are compromised or interrupted leading to the development of delayed union and nonunion fractures. Noninvasive bone growth stimulators using pulsed electromagnetic field (PEMF) technology are currently in widespread use by patients with impaired fracture healing. This article reports the results of a follow-up study of 1,382 patients treated with PEMF stimulation to evaluate success rates and the relationship between average daily use and the clinical outcomes of therapy as reported by their prescribing physicians. The reported overall success rate for the 1,382 patients was 89.6%. The results were analyzed in audited subsets comparing days of treatment time and average daily use of the electrical bone growth stimulator, using several statistical methods. Linear regression analysis indicated a 6-day reduction in time to heal with each additional hour of average daily use. Survival analysis concluded that the median heal time was reduced by 35%-60%, depending on the different fracture characteristics of patients who complied with the recommended daily use of 10 hours per day. A third statistical analysis indicated that patients treated with the PEMF device for 9 hours or more per day had a significant reduction in time to heal, achieving successful fracture repair an average of 76 days earlier than patients treated with the PEMF device for an average of 3 hours or less per day. Overall, these different methods of statistical analysis indicate that PEMF therapy correlates with an acceleration in the healing of nonunion fractures.
在正常骨折修复过程中，愈合在几个月内即可完成。然而，对于少数患者而言，骨修复过程会受到损害或中断，从而导致延迟愈合和骨不连骨折的发生。目前，使用脉冲电磁场（PEMF）技术的非侵入性骨生长刺激器被骨折愈合受损的患者广泛使用。本文报告了一项对1382例接受PEMF刺激治疗的患者的随访研究结果，以评估成功率以及其主治医生报告的平均每日使用时间与治疗临床结果之间的关系。报告显示，这1382例患者的总体成功率为89.6%。使用多种统计方法，在经过审核的亚组中对治疗天数和电骨生长刺激器的平均每日使用时间进行了分析。线性回归分析表明，平均每日使用时间每增加一小时，愈合时间可缩短6天。生存分析得出结论，根据符合每日推荐使用10小时的患者的不同骨折特征，中位愈合时间可缩短35%-60%。第三种统计分析表明，每天使用PEMF设备9小时或更长时间的患者愈合时间显著缩短，与平均每天使用PEMF设备3小时或更短时间的患者相比，骨折成功修复的时间平均提前76天。总体而言，这些不同的统计分析方法表明，PEMF疗法与骨不连骨折愈合加速相关。
