Nyberg, C.P. (2021) Evaluating the effectiveness of OssaTec bone growth stimulators in the treatment for delayed- and non-union after fractures or arthrodesis. thesis, Medicine.
Full text available on request.Abstract
Background: Approximately 10% of fractures and 12% of arthrodesis are non-unifying, causing pain, functional impairment, risk of depression and increased health care costs. Non�unifying fractures are referred to as delayed- or non-unions. Current treatment consists of surgical fixation and bone grafting, which is costly, invasive and not always suitable. Non�invasive treatment alternatives are bone growth stimulators such as pulsed electromagnetic field stimulation (PEMF). PEMFs generate electrical currents which induces bone formation by activating adenosine receptors, upregulating growth factors and extracellular matrix components. PEMF requires months of use and lacks reliable clinical research. Therefore, PEMF is not part of standard treatment. Aim: Calculate the effectiveness of PEMF on delayed- or non-union based on radiological signs and analyze influence of patient characteristics on PEMF therapy such as age, medical history, smoking, ASA-score, and medication. Methods: This is a retrospective study of 120 delayed�and non-union patients treated with OssaTec© PEMF in the Martini Hospital between 2009- 2020. Imaging was examined with assistance of an orthopedic surgeon. Data was collected from the electronic patient file system and analyzed using logistic regression. Results: Union was seen in 34 of 53 patients with a fracture (60%) and zero out of six arthrodesis. The number of months before starting PEMF had the highest relationship with union rate, however this was not significant (p=0,206). None of the independent patient characteristics collected, were shown to significantly affect union rate. Conclusion: In this heterogeneous cohort PEMF lead to a low union rate compared to other studies (53% vs. 75-80%). This could be explained by small sample size, heterogeneity in diagnostic criteria and original diagnosis. Used in its current form, PEMF is only about 60% effective in the treatment of delayed and non-union fractures and showed no effect on arthrodesis and was not comparable to surgical treatment (80%).
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Raaij, T.M. van |
| Faculty: | Medical Sciences |
| Date Deposited: | 06 Jan 2022 11:26 |
| Last Modified: | 06 Jan 2022 11:26 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2973 |
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