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电磁场联合治疗促进骨修复和再生:绵羊 3mm 和 17mm 胫骨切开术模型的研究。

Combined electric and magnetic field therapy for bone repair and regeneration: an investigation in a 3-mm and an augmented 17-mm tibia osteotomy model in sheep.

机构信息

Musculoskeletal Research Unit (MSRU), University of Zürich, Winterthurerstrasse 260, 8057, Zürich, Switzerland.

Center for Applied Biotechnology and Molecular Medicine (CABMM), University of Zürich, Zürich, Switzerland.

出版信息

J Orthop Surg Res. 2023 Jun 24;18(1):454. doi: 10.1186/s13018-023-03910-6.

Abstract

BACKGROUND

Therapies using electromagnetic field technology show evidence of enhanced bone regeneration at the fracture site, potentially preventing delayed or nonunions.

METHODS

Combined electric and magnetic field (CEMF) treatment was evaluated in two standardized sheep tibia osteotomy models: a 3-mm non-critical size gap model and a 17-mm critical size defect model augmented with autologous bone grafts, both stabilized with locking compression plates. CEMF treatment was delivered across the fracture gap twice daily for 90 min, starting 4 days postoperatively (post-OP) until sacrifice (9 or 12 weeks post-OP, respectively). Control groups received no CEMF treatment. Bone healing was evaluated radiographically, morphometrically (micro-CT), biomechanically and histologically.

RESULTS

In the 3-mm gap model, the CEMF group (n = 6) exhibited higher callus mineral density compared to the Control group (n = 6), two-fold higher biomechanical torsional rigidity and a histologically more advanced callus maturity (no statistically significant differences). In the 17-mm graft model, differences between the Control (n = 6) and CEMF group (n = 6) were more pronounced. The CEMF group showed a radiologically more advanced callus, a higher callus volume (p = 0.003) and a 2.6 × higher biomechanical torsional rigidity (p = 0.024), combined with a histologically more advanced callus maturity and healing.

CONCLUSIONS

This study showed that CEMF therapy notably enhanced bone healing resulting in better new bone structure, callus morphology and superior biomechanical properties. This technology could transform a standard inert orthopedic implant into an active device stimulating bone tissue for accelerated healing and regeneration.

摘要

背景

利用电磁场技术的治疗方法显示出在骨折部位增强骨再生的证据,有可能预防延迟愈合或不愈合。

方法

在两种标准化绵羊胫骨截骨模型中评估了组合电场和磁场(CEMF)治疗:一种 3mm 非临界尺寸间隙模型和一种 17mm 临界尺寸缺陷模型,均用自体骨移植物增强,并使用锁定加压板稳定。CEMF 治疗在术后 4 天(术后)开始每天两次穿过骨折间隙进行,每次 90 分钟,直至处死(分别为术后 9 或 12 周)。对照组未接受 CEMF 治疗。通过放射照相、形态计量学(微 CT)、生物力学和组织学评估骨愈合。

结果

在 3mm 间隙模型中,CEMF 组(n=6)与对照组(n=6)相比,骨痂矿物质密度更高,生物力学扭转刚度高两倍,组织学上骨痂成熟度更高(无统计学显著差异)。在 17mm 移植物模型中,对照组(n=6)和 CEMF 组(n=6)之间的差异更为明显。CEMF 组表现出更先进的放射学骨痂,更高的骨痂体积(p=0.003)和 2.6 倍更高的生物力学扭转刚度(p=0.024),结合更先进的组织学骨痂成熟和愈合。

结论

本研究表明,CEMF 治疗显著增强了骨愈合,从而产生了更好的新骨结构、骨痂形态和更高的生物力学性能。这项技术可以将标准的惰性骨科植入物转变为一种主动装置,刺激骨组织以加速愈合和再生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8af/10290367/43ee2ec7afd2/13018_2023_3910_Fig1_HTML.jpg

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