Figueiredo José G S, de Sousa Bárbara M, Soares Dos Santos Marco P, Vieira Sandra I
Department of Medical Sciences Institute of Biomedicine (iBiMED) University of Aveiro 3810-193 Aveiro Portugal.
Department of Mechanical Engineering Centre for Mechanical Technology & Automation (TEMA) University of Aveiro 3810-193 Aveiro Portugal.
Small Sci. 2024 Feb 26;4(5):2300303. doi: 10.1002/smsc.202300303. eCollection 2024 May.
Musculoskeletal disorders are among the main causes of disease-associated disability. Moreover, the incidence and prevalence of osteoporosis and osteoarthritis, as well as the risk of bone fractures and the need for joint replacements, are expected to increase with longer life expectancy. New approaches based on electromagnetic stimulation have been developed, aiming to shorten bone healing time, attenuate osteoporosis and osteoarthritis, and increase implants' osseointegration. Inductive coupling (IC), a non-invasive methodology to deliver magnetic stimuli, has reached clinical trials and some clinical practices but is not yet considered a standard procedure. Indeed, its feasibility in clinical use is still under discussion, and optimal stimulation parameters are fairly undefined. This comprehensive review describes the research trends and applicability of IC-based therapeutics for musculoskeletal disorders, and starts identifying top-performing magnetic stimulation parameters. Insights into the magnetic stimuli setups that promote osteogenesis are provided, based on pre-clinical and clinical evidence from 117 in vivo studies in animal models and human patients. Potential cellular and molecular biomechanisms mediating IC-induced effects on osteoblasts and osteoclasts are also explored. The transversal knowledge herein delivered will hopefully support innovative designs and medical devices that will implement IC stimulation as a clinical standard and effective therapeutic for musculoskeletal disorders.
肌肉骨骼疾病是导致疾病相关残疾的主要原因之一。此外,随着预期寿命的延长,骨质疏松症和骨关节炎的发病率和患病率,以及骨折风险和关节置换需求预计都会增加。基于电磁刺激的新方法已经开发出来,旨在缩短骨愈合时间、减轻骨质疏松症和骨关节炎,并提高植入物的骨整合。感应耦合(IC)是一种传递磁刺激的非侵入性方法,已进入临床试验和一些临床实践,但尚未被视为标准程序。事实上,其在临床应用中的可行性仍在讨论中,最佳刺激参数也相当不明确。这篇综述描述了基于感应耦合的疗法在肌肉骨骼疾病中的研究趋势和适用性,并开始确定最佳的磁刺激参数。基于对动物模型和人类患者的117项体内研究的临床前和临床证据,本文提供了对促进成骨的磁刺激设置的见解。还探讨了介导感应耦合对成骨细胞和破骨细胞诱导作用的潜在细胞和分子生物力学机制。本文提供的横向知识有望支持创新设计和医疗设备,将感应耦合刺激作为肌肉骨骼疾病的临床标准和有效治疗方法。
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