Pulsed electromagnetic fields for osteogenesis and repair

The failure of fractures to unite presents a challenging problem in orthopaedics. Randomized controlled double-blind clinical trials report the successful use of pulsed electromagnetic fields in the treatment of recalcitrant bone fractures in humans. This review examines the theoretical basis underlying the use of electromagnetic fields for osteogenesis and repair, and identifies the expanding range of clinical applications for which pulsed electromagnetic fields may be used. Basic science research is briefly reviewed to identify the mechanisms through which pulsed electromagnetic fields modulate the cellular processes inherent to bone growth and repair. Clinical trials are examined to evaluate the efficacy of this non-invasive technique in clinical applications, including fracture non-union, osteotomy, implant restabilization, osteoporosis, osteonecrosis and osteoarthritis.