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Vol.XXXVII, Suppl. 1 - Giornale Italiano di Ortopedia e Traumatologia

Vol.XXXVII, Suppl. 1 - Giornale Italiano di Ortopedia e Traumatologia

Vol.XXXVII, Suppl. 1 - Giornale Italiano di Ortopedia e Traumatologia

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EspEriEnZa cLinica: stiMoLaZionE dEL tEssuto ossEo<br />

ricerca clinica <strong>di</strong> alto livello dalla quale emerge come la<br />

stimolazione elettrica dell’osteogenesi rappresenti un’arma<br />

effi cace nelle mani dell’ortope<strong>di</strong>co allorquando vengano<br />

poste correttamente la <strong>di</strong>agnosi e la in<strong>di</strong>cazioni.<br />

In presenza <strong>di</strong> pseudoartrosi atrofi che, malallineamenti<br />

e per<strong>di</strong>ta <strong>di</strong> sostanza superiori ad 1,5 cm dovrà essere<br />

eseguito un trattamento ortope<strong>di</strong>co prima <strong>di</strong> eseguire<br />

quello biofi sico. Il trattamento biofi sico deve essere<br />

seguito dall’ortope<strong>di</strong>co il quale, se non osserva risultati<br />

dopo 45-90 giorni, dovrà prendere in considerazioni<br />

Bibliografi a<br />

1 Basset CAL, Becker RO. Generation of electric<br />

potentials in bone in response to mechanical<br />

stress. Science 1962;137:1063-4, .<br />

2 Fukada E, Yasuda I. On the piezoelectric effect<br />

of bone. J Phys Soc Japan 1957;12:121-8.<br />

3 Yasuda I, Noguchi K, Sata T. Dinamic callus<br />

and electric callus. J Bone Joint Sur<br />

1953;37A:1292-3.<br />

4 Sollazzo M, Delvecchio E, Pellegrini<br />

N, et al. Effect of low potential continuous<br />

electric currents on bone fractures in<br />

dogs: clinical, ra<strong>di</strong>ological and anatomohistopathological<br />

fi n<strong>di</strong>ngs. Experimental<br />

study. Preliminary note. Chir Organi Mov<br />

1968;58:109-20.<br />

5 Cadossi R, Traina GC. La biofi sica clinica.<br />

In: Traina GC, Pipino F, Massari L, et al.,<br />

eds. Modulazione biofi sica dell’osteogenesi<br />

me<strong>di</strong>ante campi elettromagnetici pulsati.<br />

Lugo <strong>di</strong> Romagna (Ravenna): Walberti E<strong>di</strong>tore<br />

1999, p. 39.<br />

6 Cadossi R, Caruso G, Setti S, et al. Fattori<br />

fi sici <strong>di</strong> stimolazione ossea. GIOT<br />

2007;33(<strong>Suppl</strong> 1):S255-61.<br />

7 Sollazzo V, Massari L, Bertolani G et al.<br />

Effetto dei Campi elettromagnetici pulsanti<br />

sulla proliferazione cellulare <strong>di</strong> osteoblasti<br />

umani: stu<strong>di</strong>o in vitro. GIOT 1998;24:365-<br />

74.<br />

8 Nelson FR, Brighton CT, Ryaby J, et al. Use of<br />

physical forces in bone healing. J Am Acad<br />

Orthop Surg 2003;11:344-54.<br />

9 Goodman EM, Greenebaum B, Marron MT.<br />

Effects of electromagnetic fi elds on molecules<br />

and cells. Int Rev Cytol 1995;158:279-<br />

338.<br />

10 Cadossi R, Bersani F, Cossarizza A, et al.<br />

Lymphocytes and low-frequency electromagnetic<br />

fi elds. FASEB J 1992;6:2667-74.<br />

11 Ciombor DM, Aaron RK, Wang S, et al.<br />

Mo<strong>di</strong>fi cation of osteoarthritis by pulsed electromagnetic<br />

fi eld: a morphological study.<br />

Osteoarthritis Cartilage 2003;11:455-62.<br />

12 De Mattei M, Caruso A, Traina GC, et al.<br />

Correlation between pulsed electromagnetic<br />

fi elds exposure time and cell proliferation<br />

increase in human osteosarcoma cell lines<br />

and human normal osteoblast cells in vitro.<br />

Bioelectromagnetics 1999;20:177-82.<br />

13 Pezzetti F, De Mattei M, Caruso A, et al. Effects<br />

of pulsed electromagnetic fi elds on human<br />

chondrocytes: an in vitro study. Calcif<br />

Tissue Int 1999;65:396-401.<br />

14 Sollazzo V, Massari L, Caruso C, et al. Effects<br />

of low-frequency pulsed electromagnetic<br />

fi elds on human osteoblast-like cells in vitro.<br />

Electro- and Magnetobiology 1996;15:75-<br />

83.<br />

15 Sollazzo V, Traina GC, DeMattei M, et al.<br />

Responses of human MG-63 osteosarcoma<br />

cell line and human osteoblast-like cells to<br />

pulsed electromagnetic fi elds. Bioelectromagnetics<br />

1997;18:541-7.<br />

16 Brighton CT, Wang W, Seldes R, et al. Signal<br />

transduction in electrically stimulated bone<br />

cells. J Bone Joint Surg Am 2001;83:1514-<br />

23.<br />

17 Aaron RK, Ciombor DM. Acceleration of<br />

experimental endochondral ossifi cation by<br />

biophysical stimulation of the progenitor cell<br />

pool. J Orthop Res 1996;14:582-9.<br />

18 Aaron RK, Ciombor DM, Jolly G. Stimulation<br />

of experimental endochondral ossifi cation by<br />

low-energy pulsing electromagnetic fi elds. J<br />

Bone Miner Res 1989;4:227-33.<br />

19 Aaron RK, Ciombor DM, Keeping H, et al.<br />

Power frequency fi elds promote cell <strong>di</strong>fferentiation<br />

coincident with an increase in transforming<br />

growth factor-beta(1) expression.<br />

Bioelectromagnetics 1999;20:453-8.<br />

20 Aaron RK, Boyan BD, Ciombor DM, et al.<br />

Stimulation of growth factor synthesis by<br />

electric and electromagnetic fi elds. Clin Orthop<br />

Relat Res 2004;419:30-7.<br />

21 Clark AN, Youkey R, Liu X, et al. A1 adenosine<br />

receptor activation promotes angiogenesis<br />

and release of VEGF from monocytes.<br />

Circ Res 2007;101:1130-8.<br />

22 De Mattei M, Varani K, Masieri FF, et al. Adenosine<br />

analogs and electromagnetic fi elds<br />

inhibit prostaglan<strong>di</strong>n E2 release in bovine<br />

synovial fi broblasts. Osteoarthritis Cartilage<br />

2009;17:252-62.<br />

23 Fitzsimmons RG, Ryaby JT, Magee FP, et al.<br />

IGF-II receptor number is increased in TE-85<br />

osteosarcoma cells by combined magnetic<br />

fi elds. J Bone Miner Res 1995;10:812-9.<br />

s209<br />

altre opzioni terapeutiche. In presenza dello stimolo biofi<br />

sico è possibile l’impiego anche <strong>di</strong> trapianti ossei e<br />

fattori <strong>di</strong> crescita dei quali migliorerà l’utilizzo.<br />

In conclusione, al termine <strong>di</strong> questa carrellata sul passato<br />

e sul presente della realtà della biofi sica clinica appare<br />

lecito dare uno sguardo anche al suo imme<strong>di</strong>ato futuro<br />

dove, sulla base delle più recenti acquisizioni, si sta<br />

aprendo un altro interessante campo <strong>di</strong> ricerca che lascia<br />

prevedere l’utilizzo delle meto<strong>di</strong>che biofi siche come ausilio<br />

per la me<strong>di</strong>cina rigenerativa.<br />

24 Luben RA, Cain CD, Chen MC, Ret al. Effects<br />

of electromagnetic stimuli on bone and<br />

bone cells in vitro: inhibition of responses to<br />

parathyroid hormone by low-energy, lowfrequency<br />

fi elds. Proc Natl Acad Sci USA<br />

1982;79:4180-4.<br />

25 Varani K, Gessi S, Merighi S, et al. Effect of<br />

low frequency electromagnetic fi elds on A2A<br />

adenosine receptors in human neutrophils.<br />

Br J Pharmacol 2002;136:57-66.<br />

26 Aaron RK, Ciombor DM, Wang S, et al.<br />

Clinical biophysics: the promotion of skeletal<br />

repair by physical forces. Ann N Y Acad Sci<br />

2006;1068:513-31.<br />

27 Sollazzo V, Palmieri A, Pezzetti F et al. Effects<br />

of pulsed electromagnetic fi elds on human<br />

osteoblastlike cells (MG-63): a pilot study.<br />

Clin Orthop Relat Res 2010;468:2260-77.<br />

28 Consensus conference. In: Traina GC, Pipino<br />

F, Massari L, et al., eds. Impiego della stimolazione<br />

elettrica e magnetica in ortope<strong>di</strong>a e<br />

traumatologia. Lugo <strong>di</strong> Romagna (Ravenna):<br />

Walberti E<strong>di</strong>tore 1999, p. 15.<br />

29 Brighton CT, Friedenberg ZB, Mitchell<br />

EI, et al. Treatment of nonunion with constant<br />

<strong>di</strong>rect current. Clin Orthop Relat Res<br />

1977;(124):106-23.<br />

30 Cundy PJ, Paterson DC. A ten-year review<br />

of treatment of delayed union and nonunion<br />

with an implanted bone growth stimulator.<br />

Clin Orthop Relat Res 1990;(259):216-22.<br />

31 Heppenstall RB, Brighton CT, Esterhai JL Jr,<br />

et al. Prognostic factors in nonunion of the<br />

tibia: an evaluation of 185 cases treated<br />

with constant <strong>di</strong>rect current. J Trauma<br />

1984;24:790-5.<br />

32 Paterson D. Treatment of nonunion with a constant<br />

<strong>di</strong>rect current: a totally implantable system.<br />

Orthop Clin North Am 1984;15:47-59.<br />

33 Traina GC, Gulino G. Medullary rods as<br />

electrical conductor for osteogenic stimuli in<br />

human bone. In: Brighton CT, Black J, Pollack<br />

S, eds. Electrical properties of bone and cartilage.<br />

New York: Grune and Stratton 1979,<br />

pp. 567-79.<br />

34 de Haas WG, Watson J, Morrison DM. Noninvasive<br />

treatment of ununited fractures of the<br />

tibia using electrical stimulation. J Bone Joint<br />

Surg Br 1980;62:465-70.

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