Mit Balvantray Bhavsar1, Zhihua Han1, Thomas DeCoster2, Liudmila Leppik1, Karla Mychellyne Costa Oliveira1, John H Barker3. 1. Frankfurt Initiative for Regenerative Medicine, Experimental Trauma and Orthopedic Surgery, J.W. Goethe-University, Friedrichsheim gGmbH, Haus 97 B, 1OG, Marienburgstraße. 2, 60528, Frankfurt am Main, Germany. 2. Department of Orthopedics and Rehabilitation, University of New Mexico, Albuquerque, NM, USA. 3. Frankfurt Initiative for Regenerative Medicine, Experimental Trauma and Orthopedic Surgery, J.W. Goethe-University, Friedrichsheim gGmbH, Haus 97 B, 1OG, Marienburgstraße. 2, 60528, Frankfurt am Main, Germany. JHB121654@gmail.com.
Abstract
BACKGROUND: Electrical stimulation (EStim) has been proven to promote bone healing in experimental settings and has been used clinically for many years and yet it has not become a mainstream clinical treatment. METHODS: To better understand this discrepancy we reviewed 72 animal and 69 clinical studies published between 1978 and 2017, and separately asked 161 orthopedic surgeons worldwide about their awareness, experience, and acceptance of EStim for treating fracture patients. RESULTS: Of the 72 animal studies, 77% reported positive outcomes, and the most common model, bone, fracture type, and method of administering EStim were dog, tibia, large bone defects, and DC, respectively. Of the 69 clinical studies, 73% reported positive outcomes, and the most common bone treated, fracture type, and method of administration were tibia, delayed/non-unions, and PEMF, respectively. Of the 161 survey respondents, most (73%) were aware of the positive outcomes reported in the literature, yet only 32% used EStim in their patients. The most common fracture they treated was delayed/non-unions, and the greatest problems with EStim were high costs and inconsistent results. CONCLUSION: Despite their awareness of EStim's pro-fracture healing effects few orthopedic surgeons use it in their patients. Our review of the literature and survey indicate that this is due to confusion in the literature due to the great variation in methods reported, and the inconsistent results associated with this treatment approach. In spite of this surgeons seem to be open to using this treatment if advancements in the technology were able to provide an easy to use, cost-effective method to deliver EStim in their fracture patients.
BACKGROUND: Electrical stimulation (EStim) has been proven to promote bone healing in experimental settings and has been used clinically for many years and yet it has not become a mainstream clinical treatment. METHODS: To better understand this discrepancy we reviewed 72 animal and 69 clinical studies published between 1978 and 2017, and separately asked 161 orthopedic surgeons worldwide about their awareness, experience, and acceptance of EStim for treating fracturepatients. RESULTS: Of the 72 animal studies, 77% reported positive outcomes, and the most common model, bone, fracture type, and method of administering EStim were dog, tibia, large bone defects, and DC, respectively. Of the 69 clinical studies, 73% reported positive outcomes, and the most common bone treated, fracture type, and method of administration were tibia, delayed/non-unions, and PEMF, respectively. Of the 161 survey respondents, most (73%) were aware of the positive outcomes reported in the literature, yet only 32% used EStim in their patients. The most common fracture they treated was delayed/non-unions, and the greatest problems with EStim were high costs and inconsistent results. CONCLUSION: Despite their awareness of EStim's pro-fracture healing effects few orthopedic surgeons use it in their patients. Our review of the literature and survey indicate that this is due to confusion in the literature due to the great variation in methods reported, and the inconsistent results associated with this treatment approach. In spite of this surgeons seem to be open to using this treatment if advancements in the technology were able to provide an easy to use, cost-effective method to deliver EStim in their fracturepatients.
Entities:
Keywords:
Bone fracture healing; Electrical stimulation treatment; Literature review; Survey of orthopedic surgeons
Authors: Liudmila Leppik; Karla Mychellyne Costa Oliveira; Mit Balvantray Bhavsar; John Howard Barker Journal: Eur J Trauma Emerg Surg Date: 2020-02-20 Impact factor: 3.693
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