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Electromagnetic fields for the treatment of osteoarthritis

  • Review
  • Intervention




As the focus for osteoarthritis (OA) treatment shifts away from drug therapy, we consider the effectiveness of pulsed electric stimulation which is proven to stimulate cartilage growth on the cellular level.


1)To assess the effectiveness of pulsed electric stimulation for the treatment of osteoarthritis (OA). 2) To assess the most effective and efficient method of applying an electromagnetic field, through pulsed electromagnetic fields (PEMF) or electric stimulation, as well as the consideration of length of treatment, dosage, and the frequency of the applications.

Search methods

We searched PREMEDLINE, MEDLINE, HealthSTAR, CINAHL, PEDro, and the Cochrane Controlled Trials Register (CCTR) up to and including 2001. This included searches through the coordinating offices of the trials registries of the Cochrane Field of Physical and Related Therapies and the Cochrane Musculoskeletal Group for further published and unpublished articles. The electronic search was complemented by hand searches and experts in the area.

Selection criteria

Randomized controlled trials and controlled clinical trials that compared PEMF or direct electric stimulation against placebo in patients with OA.

Data collection and analysis

Two reviewers determined the studies to be included in the review based on inclusion and exclusion criteria (JH,VR) and extracted the data using pre-developed extraction forms for the Cochrane Musculoskeletal Group. The methodological quality of the trials was assessed by the same reviewers using a validated scale (Jadad 1996). Osteoarthritis outcome measures were extracted from the publications according to OMERACT guidelines (Bellamy 1997) and additional secondary outcomes considered.

Main results

Only three studies with a total of 259 OA patients were included in the review. Electrical stimulation therapy had a small to moderate effect on outcomes for knee OA, all statistically significant with clinical benefit ranging from 13-23% greater with active treatment than with placebo. Only 2 outcomes for cervical OA were significantly different with PEMF treatment and no clinical benefit can be reported with changes of 12% or less.

Authors' conclusions

Current evidence suggests that electrical stimulation therapy may provide significant improvements for knee OA, but further studies are required to confirm whether the statistically significant results shown in these trials confer to important benefits.






1)研究脈衝電磁場治療退化性關節炎的有效性。2)研究脈衝電磁場最有效及有效率的使用方式,pulsed electromagnetic fields (PEMF) or electric stimulation及並考慮時間、劑量、頻率。


搜尋包括PREMEDLINE, MEDLINE, HealthSTAR, CINAHL, PEDro, and the Cochrane Controlled Trials Register (CCTR) (直到2001年)。Cochrane Field of Physical and Related Therapies and the Cochrane Musculoskeletal Group,同時手動搜尋所選文章之參考文獻及徵詢專家。


含pulsed electromagnetic fields (PEMF) 或電刺激及安慰劑用於治療退化性關節炎之隨機對照試驗及控制對照試驗。


兩位作者使用預製表格獨立進行資料摘錄,並對每篇試驗研究的品質評估。結果測量用OMERACT guidelines,並考慮第二結果指標。


3篇臨床試驗(259位患者)符合納入標準。電刺激對治療膝退化性關節炎有小到中度效果,比安慰劑好13 – 23% 。頸椎退化性關節炎僅有2指標在PEMF治療有顯著差異,但改變少於12% ,無顯著臨床效益。





此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。



Plain language summary

Electrical stimulation to encourage cartilage growth might be able to improve osteoarthritis of the knee, but more research is needed to be certain.

Pulsed electric stimulation as a treatment for osteoarthritis has appeared promising since the stimulation of cartilage growth was recorded at the cellular level; its growing popularity has now called for evaluation of its effectiveness. The literature search and hand searches identified 3 trials with a total of 259 patients. All trials examined knee OA and one also performed a separate evaluation for cervical OA patients. The results of this analysis show improvements in all measurements for knee OA, but their clinical significance from a patient's perspective was questionable. Only two outcomes favoured treatment for cervical OA trial and none were considered clinically important. There were no reported side effects. The reviewers conclude that there is an urgent need for further large-scale studies of pulsed electric stimulation with a focus on knee OA to establish the clinical relevance of treatment.