Mikel L Reilingh1, Christiaan J A van Bergen2, Rogier M Gerards2, Inge C van Eekeren2, Rob J de Haan3, Inger N Sierevelt4, Gino M M J Kerkhoffs2, Rover Krips5, Duncan E Meuffels6, C N van Dijk2, Leendert Blankevoort2. 1. Orthopaedic Research Center Amsterdam, Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, the Netherlands m.l.reilingh@amc.uva.nl. 2. Orthopaedic Research Center Amsterdam, Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, the Netherlands. 3. Clinical Research Unit, Academic Medical Center, Amsterdam, the Netherlands. 4. Department of Orthopaedic Surgery, Slotervaart Hospital, Amsterdam, the Netherlands. 5. Department of Orthopaedic Surgery, Diaconessenhuis, Leiden, the Netherlands. 6. Department of Orthopaedic Surgery, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands.
Abstract
BACKGROUND:Osteochondral defects (OCDs) of the talus usually affect athletic patients. The primary surgical treatment consists of arthroscopic debridement and microfracture. Various possibilities have been suggested to improve the recovery process after debridement and microfracture. A potential solution to obtain this goal is the application of pulsed electromagnetic fields (PEMFs), which stimulate the repair process of bone and cartilage. HYPOTHESIS: The use of PEMFs after arthroscopic debridement and microfracture of an OCD of the talus leads to earlier resumption of sports and an increased number of patients that resume sports. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: A total of 68 patients were randomized to receive either PEMFs (n = 36) or placebo (n = 32) after arthroscopic treatment of an OCD of the talus. The primary outcomes (ie, the number of patients who resumed sports and time to resumption of sports) were analyzed with Kaplan-Meier curves as well as Mann-Whitney U, chi-square, and log-rank tests. Secondary functional outcomes were assessed with questionnaires (American Orthopaedic Foot and Ankle Society ankle-hindfoot score, Foot and Ankle Outcome Score, EuroQol, and numeric rating scales for pain and satisfaction) at multiple time points up to 1-year follow-up. To assess bone repair, computed tomography scans were obtained at 2 weeks and 1 year postoperatively. RESULTS: Almost all outcome measures improved significantly in both groups. The percentage of sport resumption (PEMF, 79%; placebo, 80%; P = .95) and median time to sport resumption (PEMF, 17 weeks; placebo, 16 weeks; P = .69) did not differ significantly between the treatment groups. Likewise, there were no significant between-group differences with regard to the secondary functional outcomes and the computed tomography results. CONCLUSION:PEMF does not lead to a higher percentage of patients who resume sports or to earlier resumption of sports after arthroscopic debridement and microfracture of talar OCDs. Furthermore, no differences were found in bone repair between groups. REGISTRATION: Netherlands Trial Register NTR1636.
RCT Entities:
BACKGROUND:Osteochondral defects (OCDs) of the talus usually affect athletic patients. The primary surgical treatment consists of arthroscopic debridement and microfracture. Various possibilities have been suggested to improve the recovery process after debridement and microfracture. A potential solution to obtain this goal is the application of pulsed electromagnetic fields (PEMFs), which stimulate the repair process of bone and cartilage. HYPOTHESIS: The use of PEMFs after arthroscopic debridement and microfracture of an OCD of the talus leads to earlier resumption of sports and an increased number of patients that resume sports. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: A total of 68 patients were randomized to receive either PEMFs (n = 36) or placebo (n = 32) after arthroscopic treatment of an OCD of the talus. The primary outcomes (ie, the number of patients who resumed sports and time to resumption of sports) were analyzed with Kaplan-Meier curves as well as Mann-Whitney U, chi-square, and log-rank tests. Secondary functional outcomes were assessed with questionnaires (American Orthopaedic Foot and Ankle Society ankle-hindfoot score, Foot and Ankle Outcome Score, EuroQol, and numeric rating scales for pain and satisfaction) at multiple time points up to 1-year follow-up. To assess bone repair, computed tomography scans were obtained at 2 weeks and 1 year postoperatively. RESULTS: Almost all outcome measures improved significantly in both groups. The percentage of sport resumption (PEMF, 79%; placebo, 80%; P = .95) and median time to sport resumption (PEMF, 17 weeks; placebo, 16 weeks; P = .69) did not differ significantly between the treatment groups. Likewise, there were no significant between-group differences with regard to the secondary functional outcomes and the computed tomography results. CONCLUSION:PEMF does not lead to a higher percentage of patients who resume sports or to earlier resumption of sports after arthroscopic debridement and microfracture of talar OCDs. Furthermore, no differences were found in bone repair between groups. REGISTRATION: Netherlands Trial Register NTR1636.
Authors: Jari Dahmen; Kaj T A Lambers; Mikel L Reilingh; Christiaan J A van Bergen; Sjoerd A S Stufkens; Gino M M J Kerkhoffs Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-09-16 Impact factor: 4.342
Authors: Mit Balvantray Bhavsar; Zhihua Han; Thomas DeCoster; Liudmila Leppik; Karla Mychellyne Costa Oliveira; John H Barker Journal: Eur J Trauma Emerg Surg Date: 2019-04-06 Impact factor: 3.693
Authors: M L Reilingh; C J A van Bergen; L Blankevoort; R M Gerards; I C M van Eekeren; G M M J Kerkhoffs; C N van Dijk Journal: Knee Surg Sports Traumatol Arthrosc Date: 2015-12-28 Impact factor: 4.342
Authors: Kaj T A Lambers; Jari Dahmen; Mikel L Reilingh; Christiaan J A van Bergen; Sjoerd A S Stufkens; Gino M M J Kerkhoffs Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-07-07 Impact factor: 4.342
Authors: Jari Dahmen; Kaj T A Lambers; Mikel L Reilingh; Christiaan J A van Bergen; Sjoerd A S Stufkens; Gino M M J Kerkhoffs Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-06-27 Impact factor: 4.342
Authors: Mikel L Reilingh; Kaj T A Lambers; Jari Dahmen; Kim T M Opdam; Gino M M J Kerkhoffs Journal: Knee Surg Sports Traumatol Arthrosc Date: 2017-07-27 Impact factor: 4.342
Authors: I C M van Eekeren; C J A van Bergen; I N Sierevelt; M L Reilingh; C N van Dijk Journal: Knee Surg Sports Traumatol Arthrosc Date: 2016-02-04 Impact factor: 4.342