Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jun 18, 2020; 11(6): 285-293
Published online Jun 18, 2020. doi: 10.5312/wjo.v11.i6.285
Role of pulsed electromagnetic fields after joint replacements
Giada Lullini, Eugenio Cammisa, Stefania Setti, Iacopo Sassoli, Stefano Zaffagnini, Giulio Maria Marcheggiani Muccioli
Giada Lullini, Laboratorio di Analisi del Movimento e di valutazione funzionale protesi, IRCCS Istituto Ortopedico Rizzoli - DIBINEM - University of Bologna, Bologna 40100, Italy
Eugenio Cammisa, Iacopo Sassoli, Stefano Zaffagnini, Giulio Maria Marcheggiani Muccioli, II Orthopaedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli - DIBINEM - University of Bologna, Bologna 40100, Italy
Stefania Setti, Laboratory of Clinical Biophysics, IGEA S.p.A. Clinical Biophysics, 41012 Carpi (Mo), Italy
Author contributions: Lullini G conceived the study idea, and designed the research with Marcheggiani Muccioli GM; Cammisa E and Sassoli I wrote the manuscript, collected and analyzed the data, Lullini G, Setti S and Zaffagnini S edited and revised the manuscript.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Giulio Maria Marcheggiani Muccioli, MD, PhD, Academic Research, Adjunct Professor, Doctor, II Orthopaedic and Traumatology Clinic, IRCCS Istituto Ortopedico Rizzoli - DIBINEM - University of Bologna, via Pupilli 1, Bologna 40100, Italy. marcheggianimuccioli@me.com
Received: March 1, 2020
Peer-review started: March 2, 2020
First decision: April 26, 2020
Revised: May 14, 2020
Accepted: May 28, 2020
Article in press: May 28, 2020
Published online: June 18, 2020
Abstract

Although the rate of patients reporting satisfaction is generally high after joint replacement surgery, up to 23% after total hip replacement and 34% after total knee arthroplasty of treated subjects report discomfort or pain 1 year after surgery. Moreover, chronic or subacute inflammation is reported in some cases even a long time after surgery. Another open and debated issue in prosthetic surgery is implant survivorship, especially when related to good prosthesis bone ingrowth. Pulsed Electro Magnetic Fields (PEMFs) treatment, although initially recommended after total joint replacement to promote bone ingrowth and to reduce inflammation and pain, is not currently part of usual clinical practice. The purpose of this review was to analyze existing literature on PEMFs effects in joint replacement surgery and to report results of clinical studies and current indications. We selected all currently available prospective studies or RCT on the use of PEMFs in total joint replacement with the purpose of investigating effects of PEMFs on recovery, pain relief and patients’ satisfaction following hip, knee or shoulder arthroplasty. All the studies analyzed reported no adverse effects, and good patient compliance to the treatment. The available literature shows that early control of joint inflammation process in the first days after surgery through the use of PEMFs should be considered an effective completion of the surgical procedure to improve the patient’s functional recovery.

Keywords: Pulsed electromagnetic fields, Joint replacement, Osteointegration, Prosthesis outcome, Pain, Inflammation

Core tip: Pulsed Electro Magnetic Fields are a safe treatment, generally well tolerated by the patients. They have been shown to aid the recovery after joint substitution surgery, acting as an inflammation modulator and reducing pain in the first months after surgery. Further studies should be conducted on the long-term effects of PEMFs on implants integration and survival.