The Journal of Bone and Joint Surgery, Vol 65, Issue 4 480-485, Copyright © 1983 by Journal of Bone and Joint Surgery, Inc
The use of pulsing electromagnetic fields to achieve arthrodesis of the knee following failed total knee arthroplasty. A preliminary report
LU Bigliani, MP Rosenwasser, N Caulo, MM Schink and CA Bassett
Treatment with pulsing electromagnetic fields was used as an adjunct in
twenty patients who had had a knee arthrodesis after failure of a total
joint arthroplasty. Eighteen had had an infected arthroplasty; one,
mechanical loosening; and one, recurrent dislocation. Arthrodesis had been
attempted twenty-five times in these twenty patients prior to application
of the coils. These procedures included the use of twenty-two external
fixation frames, one compression plate, one intramedullary rod, and one
cylinder cast. Two groups of patients were identified: those with non-union
and those with delayed union. Fourteen patients began treatment six months
or more after arthrodesis and were considered to have a non-union. The
other six patients started treatment less than six months after attempted
arthrodesis because there was no evidence of progression toward union. They
were considered to have delayed union. In seventeen (85 per cent) of the
twenty patients a clinically solid arthrodesis with roentgenographic
evidence of bone-bridging was achieved. The average time to union after
coil therapy was started was 5.8 months, with a range of three to twelve
months. The patients who started coil treatment earlier after arthrodesis
showed a tendency to heal faster. The three patients who had failures were
the only ones who did not adhere to the protocol, and all three were in the
non-union group. All patients with a solid arthrodesis were free of pain
and able to walk at the time of follow-up, nine to thirty-one months after
the completion of treatment. The use of pulsing electromagnetic fields
appears to be a valuable non-invasive adjunct when performing arthrodesis
of the knee after failed total joint arthroplasty.