Torn Rotator Cuff
The post‐surgery integrity of the tendons and muscle quality are the two major factors in the success of rotator cuff (RC) repair. Though surgical techniques for rotator cuff repair have significantly improved in the past two decades, there are no effective treatments to improve tendon‐to‐bone healing and muscle quality after repair at this point in time. Pulsed electromagnetic fields (PEMF) have previously been used for promoting fracture healing and previous studies have shown that PEMF has a positive role in promoting osteoblast precursors proliferation and differentiation. Additionally, in a research article titled 'Role of pulsed electromagnetic fields (PEMF) on tenocytes and myoblasts—potential application for treating rotator cuff tears' published in the Journal of Orthopaedic Research the authors summary concluded, " our findings in this study suggest that PEMF has a significant effect on myoblasts and tenocytes, and could potentially serve as a safe and effective measure to promote tendon integrity and muscle regeneration after rotator cuff injuries."
We have used PEMF therapy in our office with good success concerning rotator cuff injuries, with most experiencing a decrease in pain, and an increased range of motion (ROM).
REFERENCES:
1 Yamamoto A, Takagishi K, Osawa T, et al. 2010. Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elbow Surg 19: 116– 120.
Crossref PubMed Web of Science®Google Scholar
2 Vitale MA, et al. 2007. Rotator cuff repair: an analysis of utility scores and cost‐effectiveness. J Shoulder Elbow Surg 16: 181– 187.
Crossref PubMed Web of Science®Google Scholar
3 Kim JH, et al. 2014. Retear rate in the late postoperative period after arthroscopic rotator cuff repair. Am J Sports Med 42: 2606– 2613.
Crossref PubMed Web of Science®Google Scholar
4 Vastamaki M, Lohman M, Borgmastars N. 2013. Rotator cuff integrity correlates with clinical and functional results at a minimum 16 years after open repair. Clin Orthop Relat Res 471: 554– 561.
Crossref PubMed Web of Science®Google Scholar
5 Goutallier D, et al. 2003. Influence of cuff muscle fatty degeneration on anatomic and functional outcomes after simple suture of full‐thickness tears. J Shoulder Elbow Surg 12: 550– 554.
Crossref PubMed Web of Science®Google Scholar
6 Nakagaki K, et al. 1996. Fatty degeneration in the supraspinatus muscle after rotator cuff tear. J Shoulder Elbow Surg 5: 194– 200.
Crossref CAS PubMed Google Scholar
7 Barton ER, et al. 2005. Rat supraspinatus muscle atrophy after tendon detachment. J Orthop Res 23: 259– 265.
Wiley Online Library PubMed Web of Science®Google Scholar
8 Zanetti M, Gerber C, Hodler J. 1998. Quantitative assessment of the muscles of the rotator cuff with magnetic resonance imaging. Invest Radiol 33: 163– 170.
Crossref CAS PubMed Web of Science®Google Scholar
9 Goutallier D, Postel JM, Bernageau J, et al. 1994. Fatty muscle degeneration in cuff ruptures. Pre‐ and postoperative evaluation by CT scan. Clin Orthop Relat Res 78– 83.
CAS PubMed Web of Science®Google Scholar
10 Coleman SH, et al. 2003. Chronic rotator cuff injury and repair model in sheep. J Bone Joint Surg Am 85‐A: 2391– 2402.
Crossref PubMed Web of Science®Google Scholar
11 Safran O, et al. 2005. Changes in rotator cuff muscle volume, fat content, and passive mechanics after chronic detachment in a canine model. J Bone Joint Surg Am 87: 2662– 2670.
Crossref PubMed Web of Science®Google Scholar
12 Gladstone JN, et al. 2007. Fatty infiltration and atrophy of the rotator cuff do not improve after rotator cuff repair and correlate with poor functional outcome. Am J Sports Med 35: 719– 728.
Crossref PubMed Web of Science®Google Scholar
13 Gerber C, Fuchs B, Hodler J. 2000. The results of repair of massive tears of the rotator cuff. J Bone Joint Surg Am 82: 505– 515.
Crossref CAS PubMed Web of Science®Google Scholar
14 Gerber C, et al. 2004. Effect of tendon release and delayed repair on the structure of the muscles of the rotator cuff: an experimental study in sheep. J Bone Joint Surg Am 86‐A: 1973–1982.
Google Scholar
15 Cofield RH, et al. 2001. Surgical repair of chronic rotator cuff tears. A prospective long‐term study. J Bone Joint Surg Am 83‐A: 71– 77.
Crossref CAS PubMed Web of Science®Google Scholar
16 Mellado JM, et al. 2005. Surgically repaired massive rotator cuff tears: MRI of tendon integrity, muscle fatty degeneration, and muscle atrophy correlated with intraoperative and clinical findings. AJR Am J Roentgenol 184: 1456– 1463.
Crossref CAS PubMed Web of Science®Google Scholar
17 Markov MS. 2007. Expanding use of pulsed electromagnetic field therapies. Electromagn Biol Med 26: 257– 274.
Crossref PubMed Web of Science®Google Scholar
18 Mooney V. 1990. A randomized double‐blind prospective study of the efficacy of pulsed electromagnetic fields for interbody lumbar fusions. Spine (Phila Pa 1976) 15: 708– 712.
Crossref CAS PubMed Web of Science®Google Scholar
19 Chalidis B, et al. 2011. Stimulation of bone formation and fracture healing with pulsed electromagnetic fields: biologic responses and clinical implications. Int J Immunopathol Pharmacol, 24: 17–20.
Crossref PubMed Web of Science®Google Scholar
20 Yan JL, et al. 2015. Pulsed electromagnetic fields promote osteoblast mineralization and maturation needing the existence of primary cilia. Mol Cell Endocrinol 404: 132– 140.
Crossref CAS PubMed Web of Science®Google Scholar
21 Barnaba S, et al. 2013. Effect of pulsed electromagnetic fields on human osteoblast cultures. Physiother Res Int 18: 109– 114.
Wiley Online Library PubMed Google Scholar
22 Jansen JH, et al. 2010. Stimulation of osteogenic differentiation in human osteoprogenitor cells by pulsed electromagnetic fields: an in vitro study. BMC Musculoskelet Disord 11: 188.
Crossref CAS PubMed Web of Science®Google Scholar
23 Fu YC, et al. 2014. A novel single pulsed electromagnetic field stimulates osteogenesis of bone marrow mesenchymal stem cells and bone repair. PLoS ONE 9: e91581.
Crossref PubMed Web of Science®Google Scholar
24 Tsai MT, et al. 2009. Modulation of osteogenesis in human mesenchymal stem cells by specific pulsed electromagnetic field stimulation. J Orthop Res 27: 1169– 1174.
Wiley Online Library CAS PubMed Web of Science®Google Scholar
25 Boopalan PR, et al. 2011. Pulsed electromagnetic field therapy results in healing of full thickness articular cartilage defect. Int Orthop 35: 143– 148.
Crossref PubMed Web of Science®Google Scholar
26 Choi MC, Cheung KK, Li X., et al. 2015. Pulsed electromagnetic field (PEMF) promotes collagen fibre deposition associated with increased myofibroblast population in the early healing phase of diabetic wound. Arch Dermatol Res. 307: 925– 935.
PubMed Web of Science®Google Scholar
27 Osti L, Buono AD, Maffulli N. 2015. Pulsed electromagnetic fields after rotator cuff repair: a randomized, controlled study. Orthopedics 38: e223– e228.
Crossref PubMed Web of Science®Google Scholar
28 Busch F, et al. 2012. Resveratrol modulates interleukin‐1beta‐induced phosphatidylinositol 3‐kinase and nuclear factor kappaB signaling pathways in human tenocytes. J Biol Chem 287: 38050– 38063.
Crossref CAS PubMed Web of Science®Google Scholar
29 Bernardi H, et al. 2011. Wnt4 activates the canonical beta‐catenin pathway and regulates negatively myostatin: functional implication in myogenesis. Am J Physiol Cell Physiol 300: C1122– C1138.
Crossref CAS PubMed Web of Science®Google Scholar
30 Sharma P, Maffulli N. 2005. Tendon injury and tendinopathy: healing and repair. J Bone Joint Surg Am 87: 187– 202.
Crossref PubMed Web of Science®Google Scholar
31 Greenough CG. 1996. The effect of pulsed electromagnetic fields on flexor tendon healing in the rabbit. J Hand Surg Br 21: 808– 812.
Crossref CAS PubMed Web of Science®Google Scholar
32 Robotti E, et al. 1999. The effect of pulsed electromagnetic fields on flexor tendon healing in chickens. J Hand Surg Br 24: 56– 58.
Crossref CAS PubMed Web of Science®Google Scholar
33 Lee EW, et al. 1997. Pulsed magnetic and electromagnetic fields in experimental achilles tendonitis in the rat: a prospective randomized study. Arch Phys Med Rehabil 78: 399– 404.
Crossref CAS PubMed Web of Science®Google Scholar
34 Lin Y, et al. 1992. Effects of pulsing electromagnetic fields on the ligament healing in rabbits. J Vet Med Sci 54: 1017– 1022.
Crossref CAS PubMed Web of Science®Google Scholar
35 Denaro V, et al. 2011. Effect of pulsed electromagnetic fields on human tenocyte cultures from supraspinatus and quadriceps tendons. Am J Phys Med Rehabil 90: 119– 127.
Crossref PubMed Web of Science®Google Scholar
36 Yablonka‐Reuveni Z. 1995. Development and postnatal regulation of adult myoblasts. Microsc Res Tech 30: 366– 380.
Wiley Online Library CAS PubMed Web of Science®Google Scholar
37 Campion DR. 1984. The muscle satellite cell: a review. Int Rev Cytol 87: 225–251.
Web of Science®Google Scholar
38 White TP, Esser KA. 1989. Satellite cell and growth factor involvement in skelmuscle growth. Med Sci Sports Exerc 21: S158– S163.
Crossref CAS PubMed Web of Science®Google Scholar
39 Abmayr SM, Pavlath GK. 2012. Myoblast fusion: lessons from flies and mice. Development 139: 641– 656.
Crossref CAS PubMed Web of Science®Google Scholar
40 Leon‐Salas WD, et al. 2013. A dual mode pulsed electro‐magnetic cell stimulator produces acceleration of myogenic differentiation. Recent Pat Biotechnol 7: 71– 81.
Crossref CAS PubMed Google Scholar
41 Gumucio JP, et al. 2012. Rotator cuff tear reduces muscle fiber specific force production and induces macrophage accumulation and autophagy. J Orthop Res 30: 1963– 1970.
Wiley Online Library CAS PubMed Web of Science®Google Scholar
42 Mendias CL, et al. 2015. Reduced muscle fiber force production and disrupted myofibril architecture in patients with chronic rotator cuff tears. J Shoulder Elbow Surg 24: 111– 119.
Crossref PubMed Web of Science®Google Scholar
43 Oak NR, et al. 2014. Inhibition of 5‐LOX, COX‐1, and COX‐2 increases tendon healing and reduces muscle fibrosis and lipid accumulation after rotator cuff repair. Am J Sports Med 42: 2860– 2868.
Crossref PubMed Web of Science®Google Scholar
44 Yao L, et al. 2011. Non‐immortalized human tenocyte cultures as a vehicle for understanding cellular aspects to tendinopathy. Transl Med UniSa 1: 173– 194.
PubMed Google Scholar
45 Yao L, et al. 2006. Phenotypic drift in human tenocyte culture. Tissue Eng 12: 1843– 1849.
Crossref CAS PubMed Web of Science®Google Scholar