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Application of pulsed electromagnetic fields after microfractures to the knee: a mid-term study

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Abstract

Purpose

Pulsed electromagnetic fields (PEMFs) may improve clinical outcomes following microfractures and prevent their decline over time.

Methods

Sixty-eight patients who underwent partial medial meniscectomy and microfractures to the medial femoral condyle for management of grade III–IV cartilage lesions were randomly divided into two groups using a block randomization procedure. After surgery, 34 patients underwent PEMFs application in the I-ONE group; 34 patients underwent placebo treatment in the placebo group. All patients had the same postoperative rehabilitation protocol. Sixty patients (28 in the I-ONE group, 32 in the placebo group) were assessed at an intermediate follow-up of two years and a minimum follow-up of five years after surgery.

Results

The two groups were homogeneous. There was a significant improvement from baseline to the last minimum follow up of two years. At two years, IKDC and Lysholm and Constant scores were significantly improved compared to baseline in both groups with no significant inter-group differences. At the last follow up (minimum five years), clinical and functional outcomes were decreased in both the groups, with significant better outcomes in the I-ONE group. At five years, the percentage of patients still active at the same level they were pre-operatively was greater in the I-ONE group (82 % vs 68 %, P = 0.28). At radiographic assessment, at the latest evaluation, six patients (21.4 %) in the I-ONE group and nine (28.1 %) in the placebo group demonstrated grade I–II degenerative changes according to Fairbank grading system (Χ = 0.36, P = 0.55).

Conclusions

PEMFs application can improve the effectiveness of microfracture in the long term.

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Conflict of interest

The authors disclose they have no conflict of interest.

Author information

Authors and Affiliations

  1. Unit of Arthroscopy and Sports Trauma Surgery, Hesperia Hospital, Via Arquà 80/b, Modena, Italy

    Leonardo Osti

  2. Department of Orthopaedics and Traumatology, Sant’Anna Hospital, Via Ravona, San Fermo della Battaglia (Como), Italy

    Angelo Del Buono

  3. Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London, E1 4DG, UK

    Nicola Maffulli

Authors
  1. Leonardo Osti
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  2. Angelo Del Buono
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  3. Nicola Maffulli
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Correspondence to Nicola Maffulli.

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Osti, L., Del Buono, A. & Maffulli, N. Application of pulsed electromagnetic fields after microfractures to the knee: a mid-term study. International Orthopaedics (SICOT) 39, 1289–1294 (2015). https://doi.org/10.1007/s00264-014-2627-0

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  • DOI: https://doi.org/10.1007/s00264-014-2627-0

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