Application of Pulsed Electromagnetic Fields in Foot and Ankle Surgery

Abstract

Over the last few decades, significant efforts have been made to more clearly elucidate the role of electrical stimulation devices in orthopedic surgery. Pulsed electromagnetic field (PEMF) devices have been established as an adjunct treatment modality for not only nonunions but also for fracture management, failed arthrodeses, and congenital pseudarthrosis. More recently, research has focused on exploring the scope of applications in orthopedic surgery appropriate for PEMF and the specific mechanisms by which PEMF modulates bone healing. A literature review was conducted to examine the use and benefits of PEMF. Multiple in vitro and in vivo studies were reviewed. The existing literature reporting on application of PEMF in foot and ankle surgery is quite limited, with most studies reporting on the use of PEMF in primary and revision foot and ankle arthrodeses. Strong level I clinical studies evaluating the role of PEMF in foot and ankle surgery, particularly, are currently lacking. The use of PEMF is supported primarily by successes in the treatment of long bone delayed unions and nonunions. The routine use of PEMF in primary arthrodesis in the foot and ankle is based on limited clinical evidence at this point. Whether PEMF will prove to be an adjunct modality to revision surgery is still unclear, as further studies are needed to substantiate its use in such high-risk situations.