IRCCS Istituto Ortopedico Galeazzi, Milano, Italy.
Cartilage. 2021 Dec;13(1_suppl):1749S-1760S. doi: 10.1177/1947603520931168. Epub 2020 Jun 8.
The purpose of this systematic review and meta-analysis was to evaluate the effect of electromagnetic field treatment on the symptoms of knee osteoarthritis (OA). In addition, the influence of the type of control group and other covariates have been investigated to identify the sources of heterogeneity in the results of the available clinical trials.
Randomized controlled trials reporting pulsed electromagnetic field-based therapies for the treatment of knee OA have been included. Main outcomes were self-reported pain and activity scores collected by Visual Analogue Scale (VAS) and/or Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) at short term after treatment.
Thirteen studies comprising 914 unique patients were included in the analysis. Overall reduction in pain score was observed after treatment (standardized mean difference -0.4059, = 0.0091), while improvement in the activity score was not significant (standardized mean difference -0.4452, = 0.0859). Type of control (i.e., placebo or alternative therapies) and time of follow-up resulted as the two major elements influencing the outcomes. Indeed, the restriction of the analysis to placebo-controlled trials demonstrated higher standardized mean differences between treatment and control groups, with lower value for pain, while statistical significance became evident also for the activity score. On the contrary, no differences were observed pooling only studies comparing pulsed electromagnetic or magnetic fields to alternative treatments. In addition, longer follow-up correlated with lower differences between treated and control patients.
Pulsed electromagnetic field therapy effectively relieves knee OA symptoms at short term, but it is not superior to other conservative therapies such as physiotherapy.
本系统评价和荟萃分析旨在评估电磁场治疗对膝骨关节炎（OA）症状的影响。此外，还研究了对照组类型和其他协变量的影响，以确定现有临床试验结果中异质性的来源。
纳入了报告基于脉冲电磁场治疗膝骨关节炎的随机对照试验。主要结局是通过视觉模拟量表（VAS）和/或西安大略和麦克马斯特大学骨关节炎指数（WOMAC）在治疗后短期收集的自我报告疼痛和活动评分。
共纳入 13 项研究，包含 914 名患者。治疗后疼痛评分总体下降（标准化均数差-0.4059， = 0.0091），而活动评分改善不显著（标准化均数差-0.4452， = 0.0859）。对照组类型（即安慰剂或替代疗法）和随访时间是影响结果的两个主要因素。事实上，将分析仅限于安慰剂对照试验，显示出治疗组和对照组之间更高的标准化均数差异，疼痛的 值更低，而活动评分的统计学意义也变得明显。相反，仅将脉冲电磁场或磁场与替代疗法进行比较的研究进行汇总时，未观察到差异。此外，更长的随访时间与治疗患者和对照组患者之间的差异降低相关。
脉冲电磁场治疗可在短期内有效缓解膝骨关节炎症状，但并不优于其他保守治疗，如物理治疗。
