Department of Orthopaedics and Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
Stem Cells and Regenerative Medicine Laboratory, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China.
Am J Sports Med. 2022 Aug;50(10):2722-2732. doi: 10.1177/03635465221105874. Epub 2022 Jul 14.
Meniscal tears in the avascular region are thought to rarely heal and are a considerable challenge to treat. Although the therapeutic effects of a pulsed electromagnetic field (PEMF) have been extensively studied in a variety of orthopaedic disorders, the effect of a PEMF on meniscal healing has not been reported.
PEMF treatment would promote meniscal healing and prevent osteoarthritis progression.
Controlled laboratory study.
A total of 72 twelve-week-old male Sprague-Dawley rats with full-thickness longitudinal medial meniscal tears in the avascular region were divided into 3 groups: control (G), treatment with a classic signal PEMF (G), and treatment with a high-slew rate signal PEMF (G). Macroscopic observation and histological analysis of the meniscus and articular cartilage were performed to evaluate the meniscal healing and progression of osteoarthritis. The synovium was harvested for histological and immunofluorescent analysis to evaluate the intra-articular inflammation. Meniscal healing, articular cartilage degeneration, and synovitis were quantitatively evaluated according to their scoring systems.
Dramatic degenerative changes of the meniscus and articular cartilage were noticed during gross observation and histological evaluation in G at 8 weeks. However, the menisci in the 2 treatment groups were restored to normal morphology, with a smooth surface and shiny white color. Particularly, the HSR signal remarkably enhanced the fibrochondrogenesis and accelerated the remodeling process of the regenerated tissue. The meniscal healing scores of the PEMF treatment groups were significantly higher than those in G at 8 weeks. Specifically, the HSR signal showed a significantly higher meniscal repair score than did the classic signal at week 8 ( < .01). Additionally, the HSR signal significantly downregulated the secretion levels of interleukin 1 beta (IL-1β) and tumor necrosis factor alpha (TNF-α) in the meniscus and synovium as compared with the control group. When compared with the 2 treatment groups, G had significantly higher degeneration scores (G vs G, < .0001; G vs G, < .0001). The HSR signal also exhibited significantly lower synovitis scores compared with the other two groups (G vs G, < .0001; G vs G, = .0002).
A PEMF promoted the healing of meniscal tears in the avascular region and restored the injured meniscus to its structural integrity in a rat model. As compared with the classic signal, the HSR signal showed increased capability to promote fibrocartilaginous tissue formation and modulate the inflammatory environment, therefore protecting the knee joint from posttraumatic osteoarthritis development.
Adjuvant PEMF therapy may offer a new approach for the treatment of meniscal tears attributed to the enhanced meniscal repair and ameliorated osteoarthritis progression.
人们认为，在无血管区域的半月板撕裂很少能愈合，因此治疗起来极具挑战性。虽然脉冲电磁场（PEMF）的治疗效果已在多种骨科疾病中得到广泛研究，但 PEMF 对半月板愈合的影响尚未见报道。
PEMF 治疗可促进半月板愈合并预防骨关节炎进展。
对照实验室研究。
将 72 只 12 周龄雄性 Sprague-Dawley 大鼠分为 3 组：对照组（G）、经典信号 PEMF 治疗组（G）和高斜率率信号 PEMF 治疗组（G）。对半月板和关节软骨进行大体观察和组织学分析，以评估半月板愈合和骨关节炎进展情况。采集滑膜进行组织学和免疫荧光分析，以评估关节内炎症。根据评分系统对半月板愈合、关节软骨退变和滑膜炎进行定量评估。
在 8 周的大体观察和组织学评估中，G 组的半月板和关节软骨出现明显的退行性变化。然而，2 个治疗组的半月板恢复到正常形态，表面光滑，呈亮白色。特别是，HSR 信号显著增强了纤维软骨生成，并加速了再生组织的重塑过程。8 周时，PEMF 治疗组的半月板愈合评分明显高于 G 组（<0.01）。具体而言，与经典信号相比，HSR 信号在第 8 周时具有更高的半月板修复评分（<0.01）。此外，与对照组相比，HSR 信号显著下调了半月板和滑膜中白细胞介素 1β（IL-1β）和肿瘤坏死因子 α（TNF-α）的分泌水平。与 2 个治疗组相比，G 组的退变评分明显更高（G 与 G，<0.0001；G 与 G，<0.0001）。与其他两组相比，HSR 信号也表现出更低的滑膜炎评分（G 与 G，<0.0001；G 与 G，=0.0002）。
PEMF 促进了无血管区半月板撕裂的愈合，并使受伤的半月板恢复到结构完整性，在大鼠模型中。与经典信号相比，HSR 信号在促进纤维软骨组织形成和调节炎症环境方面表现出更强的能力，从而保护膝关节免受创伤后骨关节炎的发展。
辅助 PEMF 治疗可能为半月板撕裂的治疗提供一种新方法，因为它可以增强半月板修复和改善骨关节炎进展。
