Effect of pulsed electromagnetic field therapy in patients undergoing total knee arthroplasty: a randomised controlled trial

Paolo Adravanti, Stefano Nicoletti, Stefania Setti, Aldo Ampollini, Laura de Girolamo, Paolo Adravanti, Stefano Nicoletti, Stefania Setti, Aldo Ampollini, Laura de Girolamo

Abstract

Purpose: It has been reported that even one year after total knee arthroplasty (TKA), a relevant percentage of patients does not attain complete recovery and indicate unfavourable long-term pain outcome. We compared the clinical outcome of 33 patients undergoing TKA randomly assigned to the control or the pulsed electromagnetic field group (I-ONE therapy).

Methods: I-ONE therapy was administered postoperatively four hours per day for 60 days. Patients were assessed before surgery and then at one, two and six months postoperatively using international scores.

Results: One month after TKA, pain, knee swelling and functional score were significantly better in the treated compared with the control group. Pain was still significantly lower in the treated group at the six month follow-up. Three years after surgery, severe pain and occasional walking limitations were reported in a significantly lower number of patients in the treated group.

Conclusions: Advantages deriving from early control of joint inflammation may explain the maintenance of results at follow-up. I-ONE therapy should be considered an effective completion of the TKA procedure.

Figures

Fig. 1
Fig. 1
Consolidated Standards of Reporting Trials (CONSORT) flow chart for patient enrolment
Fig. 2
Fig. 2
Visual analogue score (VAS) pain evaluation of patients before and 1, 2 and 6 months after total knee arthroplasty (TKA). **p < 0.01; ***p < 0.001 for each follow-up vs baseline; $p < 0.05 for the pulsed electromagnetic field (I-ONE) therapy group vs control group
Fig. 3
Fig. 3
Knee Society Score (knee and function scores) of patients before surgery and at 1, 2 and 6 months after total knee arthroplasty (TKA). **p < 0.01; ***p < 0.001 for each follow up vs baseline. $p < 0.05 for the pulsed electromagnetic field ( I-ONE) therapy group vs control group
Fig. 4
Fig. 4
Swelling evaluation of patients before and 1, 2 and 6 months after total knee arthroplasty (TKA). Swelling, evaluated on palpation by the physician, is described using a scale ranging from 0 to 40, where higher scores indicate better results. *p < 0.05; **p < 0.01; ***p < 0.001 for each follow-up vs baseline. $p < 0.05; $$p < 0.01 for the pulsed magnetic field (I-ONE) therapy group vs control group
Fig. 5
Fig. 5
Short-Form Health Survey of 36 questions (SF-36) evaluation of patients before and 1, 2 and 6 months after total knee arthroplasty (TKA). *p < 0.05; **p < 0.01; ***p < 0.001 for each follow-up vs baseline
Fig. 6
Fig. 6
Long-term follow-up: percentage of patients still having severe pain (left) and occasionally requiring walking aids (right) 3 years after total knee arthroplasty (TKA). $p < 0.05 for the pulsed magnetic field (I-ONE) therapy group vs control group

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