Bigliani L U, Rosenwasser M P, Caulo N, Schink M M, Bassett C A
J Bone Joint Surg Am. 1983 Apr;65(4):480-5.
Treatment with pulsing electromagnetic fields was used as an adjunct in twenty patients who had had a knee arthrodesis after failure of a total joint arthroplasty. Eighteen had had an infected arthroplasty; one, mechanical loosening; and one, recurrent dislocation. Arthrodesis had been attempted twenty-five times in these twenty patients prior to application of the coils. These procedures included the use of twenty-two external fixation frames, one compression plate, one intramedullary rod, and one cylinder cast. Two groups of patients were identified: those with non-union and those with delayed union. Fourteen patients began treatment six months or more after arthrodesis and were considered to have a non-union. The other six patients started treatment less than six months after attempted arthrodesis because there was no evidence of progression toward union. They were considered to have delayed union. In seventeen (85 per cent) of the twenty patients a clinically solid arthrodesis with roentgenographic evidence of bone-bridging was achieved. The average time to union after coil therapy was started was 5.8 months, with a range of three to twelve months. The patients who started coil treatment earlier after arthrodesis showed a tendency to heal faster. The three patients who had failures were the only ones who did not adhere to the protocol, and all three were in the non-union group. All patients with a solid arthrodesis were free of pain and able to walk at the time of follow-up, nine to thirty-one months after the completion of treatment. The use of pulsing electromagnetic fields appears to be a valuable non-invasive adjunct when performing arthrodesis of the knee after failed total joint arthroplasty.
脉冲电磁场疗法被用作全关节置换失败后接受膝关节融合术的20例患者的辅助治疗手段。其中18例患者曾接受过感染性关节置换术；1例因机械性松动；1例因复发性脱位。在应用线圈之前，这20例患者曾尝试过25次关节融合术。这些手术包括使用22个外固定架、1个加压钢板、1个髓内棒和1个管型石膏。确定了两组患者：骨不连组和延迟愈合组。14例患者在关节融合术后6个月或更长时间开始治疗，被认为是骨不连。另外6例患者在尝试关节融合术后不到6个月开始治疗，因为没有骨愈合进展的证据，他们被认为是延迟愈合。20例患者中有17例（85%）实现了临床稳定的关节融合，X线片显示有骨桥形成。开始线圈治疗后至愈合的平均时间为5.8个月，范围为3至12个月。关节融合术后较早开始线圈治疗的患者愈合倾向更快。3例治疗失败的患者是仅有的未遵守方案的患者，且这3例均在骨不连组。所有实现稳定关节融合的患者在治疗完成后9至31个月的随访时均无疼痛且能够行走。在全关节置换失败后进行膝关节融合术时，使用脉冲电磁场似乎是一种有价值的非侵入性辅助手段。
