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Efficacy of bone stimulators in large-animal models and humans may be limited by weak electric fields reaching fracture
Noninvasive electronic bone growth stimulators (EBGSs) have been in clinical use for decades. However, systematic reviews show inconsistent and limited clinical efficacy. Further, noninvasive EBGS studies in small animals, where the stimulation electrode is closer to the fracture site, have shown pr...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9758190/ https://www.ncbi.nlm.nih.gov/pubmed/36526728 http://dx.doi.org/10.1038/s41598-022-26215-w |
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author | Verma, Nishant Le, Todd Mudge, Jonah Nicksic, Peter J. Xistris, Lillian Kasole, Maisha Shoffstall, Andrew J. Poore, Samuel O. Ludwig, Kip A. Dingle, Aaron M. |
author_facet | Verma, Nishant Le, Todd Mudge, Jonah Nicksic, Peter J. Xistris, Lillian Kasole, Maisha Shoffstall, Andrew J. Poore, Samuel O. Ludwig, Kip A. Dingle, Aaron M. |
author_sort | Verma, Nishant |
collection | PubMed |
description | Noninvasive electronic bone growth stimulators (EBGSs) have been in clinical use for decades. However, systematic reviews show inconsistent and limited clinical efficacy. Further, noninvasive EBGS studies in small animals, where the stimulation electrode is closer to the fracture site, have shown promising efficacy, which has not translated to large animals or humans. We propose that this is due to the weaker electric fields reaching the fracture site when scaling from small animals to large animals and humans. To address this gap, we measured the electric field strength reaching the bone during noninvasive EBGS therapy in human and sheep cadaver legs and in finite element method (FEM) models of human and sheep legs. During application of 1100 V/m with an external EBGS, only 21 V/m reached the fracture site in humans. Substantially weaker electric fields reached the fracture site during the later stages of healing and at increased bone depths. To augment the electric field strength reaching the fracture site during noninvasive EBGS therapy, we introduced the Injectrode, an injectable electrode that spans the distance between the bone and subcutaneous tissue. Our study lays the groundwork to improve the efficacy of noninvasive EBGSs by increasing the electric field strength reaching the fracture site. |
format | Online Article Text |
id | pubmed-9758190 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-97581902022-12-18 Efficacy of bone stimulators in large-animal models and humans may be limited by weak electric fields reaching fracture Verma, Nishant Le, Todd Mudge, Jonah Nicksic, Peter J. Xistris, Lillian Kasole, Maisha Shoffstall, Andrew J. Poore, Samuel O. Ludwig, Kip A. Dingle, Aaron M. Sci Rep Article Noninvasive electronic bone growth stimulators (EBGSs) have been in clinical use for decades. However, systematic reviews show inconsistent and limited clinical efficacy. Further, noninvasive EBGS studies in small animals, where the stimulation electrode is closer to the fracture site, have shown promising efficacy, which has not translated to large animals or humans. We propose that this is due to the weaker electric fields reaching the fracture site when scaling from small animals to large animals and humans. To address this gap, we measured the electric field strength reaching the bone during noninvasive EBGS therapy in human and sheep cadaver legs and in finite element method (FEM) models of human and sheep legs. During application of 1100 V/m with an external EBGS, only 21 V/m reached the fracture site in humans. Substantially weaker electric fields reached the fracture site during the later stages of healing and at increased bone depths. To augment the electric field strength reaching the fracture site during noninvasive EBGS therapy, we introduced the Injectrode, an injectable electrode that spans the distance between the bone and subcutaneous tissue. Our study lays the groundwork to improve the efficacy of noninvasive EBGSs by increasing the electric field strength reaching the fracture site. Nature Publishing Group UK 2022-12-16 /pmc/articles/PMC9758190/ /pubmed/36526728 http://dx.doi.org/10.1038/s41598-022-26215-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Verma, Nishant Le, Todd Mudge, Jonah Nicksic, Peter J. Xistris, Lillian Kasole, Maisha Shoffstall, Andrew J. Poore, Samuel O. Ludwig, Kip A. Dingle, Aaron M. Efficacy of bone stimulators in large-animal models and humans may be limited by weak electric fields reaching fracture |
title | Efficacy of bone stimulators in large-animal models and humans may be limited by weak electric fields reaching fracture |
title_full | Efficacy of bone stimulators in large-animal models and humans may be limited by weak electric fields reaching fracture |
title_fullStr | Efficacy of bone stimulators in large-animal models and humans may be limited by weak electric fields reaching fracture |
title_full_unstemmed | Efficacy of bone stimulators in large-animal models and humans may be limited by weak electric fields reaching fracture |
title_short | Efficacy of bone stimulators in large-animal models and humans may be limited by weak electric fields reaching fracture |
title_sort | efficacy of bone stimulators in large-animal models and humans may be limited by weak electric fields reaching fracture |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9758190/ https://www.ncbi.nlm.nih.gov/pubmed/36526728 http://dx.doi.org/10.1038/s41598-022-26215-w |
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