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Current Evidence Using PEMF in Osteoarthritis

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Publication Title | Current Evidence Using PEMF in Osteoarthritis

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Journal of
Clinical Medicine
Systematic Review
Current Evidence Using Pulsed Electromagnetic Fields in Osteoarthritis: A Systematic Review
Luigi Cianni 1,2 , Emidio Di Gialleonardo 1, Donato Coppola 1, Giacomo Capece 1,* , Eugenio Libutti 3, Massimiliano Nannerini 3, Giulio Maccauro 1,2 and Raffaele Vitiello 1,2
2 3
Abstract: (1) Background: Osteoarthritis (OA) significantly impacts patients’ quality of life and negatively affects public healthcare costs. The aim of this systematic review is to identify the effectiveness of pulsed electromagnetic fields (PEMFs) in OA treatment across different anatomi- cal districts, determining pain reduction and overall improvement in the patient’s quality of life. (2) Methods: In this systematic review following PRISMA guidelines, PubMed and Google Scholar were searched for randomized controlled trials involving patients with osteoarthritis undergoing PEMF therapy. Seventeen studies (1197 patients) were included. (3) Results: PEMF therapy demon- strated positive outcomes across various anatomical districts, primarily in knee osteoarthritis. Pain reduction, assessed through VAS and WOMAC scores, showed significant improvement (60% de- crease in VAS, 42% improvement in WOMAC). The treatment duration varied (15 to 90 days), with diverse PEMF devices used. Secondary outcomes included improvements in quality of life, reduced medication usage, and enhanced physical function. (4) Conclusions: Diverse PEMF applications revealed promising results, emphasizing pain reduction and improvement in the quality of life of patients. The variability in the treatment duration and device types calls for further investigation. This review informs future research directions and potential advancements in optimizing PEMF therapies for diverse osteoarthritic manifestations.
Keywords: pulsed electromagnetic fields; musculoskeletal disorders; osteoarthritis; application; therapy
1. Introduction
1.1. Definition and Classification
Osteoarthritis (OA) is a degenerative process primarily involving the articular cartilage, with secondary damage to the subchondral bone and synovial membranes [1].
OA can be classified as primary (idiopathic) or secondary (more frequently post- trauma or post-surgical) [2]. It is a condition that not only greatly impacts the quality of life of patients, but also has an effect on the healthcare system because of the costs related to its management [3]. It is clear from the literature that osteoarthritis is not only a condition confined to the musculoskeletal system but is also related to the onset of cardio-vascular and mental disorders [3–6].
Cartilage degeneration can be assessed using the Outerbridge Classification [7], which was developed in 1961 and is based on the direct visualization of cartilage, either arthroscopically or open, assigning a severity grade ranging from 0 (normal cartilage) to 4 (subchondral bone exposure) [8]. Although the Outerbridge Classification is widely used in the clinical field, it has many limitations, such as poor reproducibility among surgeons and no correlation with prognosis or type of treatment [8].
Citation: Cianni, L.; Di Gialleonardo, E.; Coppola, D.; Capece, G.; Libutti, E.; Nannerini, M.; Maccauro, G.; Vitiello, R. Current Evidence Using Pulsed Electromagnetic Fields in Osteoarthritis: A Systematic Review. J.Clin.Med.2024,13,1959. https://
Academic Editor: Umile Giuseppe Longo
Received: 25 February 2024 Revised: 22 March 2024 Accepted: 25 March 2024 Published: 28 March 2024
Copyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// 4.0/).
Orthopaedics and Trauma Surgery Unit, Catholic University of the Sacred Heart, 00168 Rome, Italy; (L.C.); (E.D.G.); (D.C.); (G.M.); (R.V.)
Department of Ageing, Neurosciences, Head-Neck and Orthopedics Sciences, Orthopedics and Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy
Aurelia Hospital, 00165 Rome, Italy; (E.L.); (M.N.) * Correspondence:
J. Clin. Med. 2024, 13, 1959.

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