Pulsed Electromagnetic Fields and Tissue Engineering of the joints.

BACKGROUND: Bone and cartilage joint formation, maintenance and regeneration are regulated by both chemical and physical signals. Among the physical signals there is increasing realization of the role of Pulsed electromagnetic fields (PEMF) in the treatment of nonunions of bone fractures. The discovery of the piezoelectric properties of bone by Fukada and Yasuda in 1953 in Japan established the foundation of this field. Pioneering research by Bassett and Brighton and their teams resulted in the approval by Food and Drug Administration (FDA) the use of PEMF in treatment of fracture healing. Although PEMF has potential applications in articular cartilage joint regeneration in osteoarthritis (OA) this evolving field is still in its infancy and offers novel opportunities.

METHODS: We have systematically reviewed the literature on the influence of PEMF in joints including articular cartilage, tendons and ligaments of publications from 2000 to 2016.

CONCLUSIONS: PEMF stimulated chondrocyte proliferation, differentiation and extracellular matrix synthesis by release of anabolic morphogens such as BMPs and anti-inflammatory cytokines by adenosine receptors A2A and A3 in both in vitro and in vivo investigations. It is noteworthy that in clinical translational investigations a beneficial effect was observed on improving function in OA knees. However, additional systematic studies on the mechanisms of action of PEMF on joints and tissues therein, articular cartilage, tendons and ligaments are required.

PMID: 29020880 DOI: 10.1089/ten.TEB.2017.0294