title: Effects of Pulsed Electromagnetic Fields on Return to Sports After Arthroscopic Debridement and Microfracture of Osteochondral Talar Defects: A Randomized, Double-Blind, Placebo-Controlled, Multicenter Trial.
abstract: Osteochondral defects (OCDs) of the talus usually affect athletic patients. The primary surgical treatment consists of arthroscopic debridement and microfracture. Various possibilities have been suggested to improve the recovery process after debridement and microfracture. A potential solution to obtain this goal is the application of pulsed electromagnetic fields (PEMFs), which stimulate the repair process of bone and cartilage.
  
  
  
  The use of PEMFs after arthroscopic debridement and microfracture of an OCD of the talus leads to earlier resumption of sports and an increased number of patients that resume sports.
  
  
  
  Randomized controlled trial; Level of evidence, 1.
  
  
  
  A total of 68 patients were randomized to receive either PEMFs (n = 36) or placebo (n = 32) after arthroscopic treatment of an OCD of the talus. The primary outcomes (ie, the number of patients who resumed sports and time to resumption of sports) were analyzed with Kaplan-Meier curves as well as Mann-Whitney U, chi-square, and log-rank tests. Secondary functional outcomes were assessed with questionnaires (American Orthopaedic Foot and Ankle Society ankle-hindfoot score, Foot and Ankle Outcome Score, EuroQol, and numeric rating scales for pain and satisfaction) at multiple time points up to 1-year follow-up. To assess bone repair, computed tomography scans were obtained at 2 weeks and 1 year postoperatively.
  
  
  
  Almost all outcome measures improved significantly in both groups. The percentage of sport resumption (PEMF, 79%; placebo, 80%; P = .95) and median time to sport resumption (PEMF, 17 weeks; placebo, 16 weeks; P = .69) did not differ significantly between the treatment groups. Likewise, there were no significant between-group differences with regard to the secondary functional outcomes and the computed tomography results.
  
  
  
  PEMF does not lead to a higher percentage of patients who resume sports or to earlier resumption of sports after arthroscopic debridement and microfracture of talar OCDs. Furthermore, no differences were found in bone repair between groups.
  
  
  
  Netherlands Trial Register NTR1636.
authors.affiliation: Orthopaedic Research Center Amsterdam, Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, the Netherlands m.l.reilingh@amc.uva.nl.
authors.forename: Mikel L
authors.initials: ML
authors.lastname: Reilingh
authors.affiliation: Orthopaedic Research Center Amsterdam, Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Christiaan J A
authors.initials: CJ
authors.lastname: van Bergen
authors.affiliation: Orthopaedic Research Center Amsterdam, Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Rogier M
authors.initials: RM
authors.lastname: Gerards
authors.affiliation: Orthopaedic Research Center Amsterdam, Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Inge C
authors.initials: IC
authors.lastname: van Eekeren
authors.affiliation: Clinical Research Unit, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Rob J
authors.initials: RJ
authors.lastname: de Haan
authors.affiliation: Department of Orthopaedic Surgery, Slotervaart Hospital, Amsterdam, the Netherlands.
authors.forename: Inger N
authors.initials: IN
authors.lastname: Sierevelt
authors.affiliation: Orthopaedic Research Center Amsterdam, Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Gino M M J
authors.initials: GM
authors.lastname: Kerkhoffs
authors.affiliation: Department of Orthopaedic Surgery, Diaconessenhuis, Leiden, the Netherlands.
authors.forename: Rover
authors.initials: R
authors.lastname: Krips
authors.affiliation: Department of Orthopaedic Surgery, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands.
authors.forename: Duncan E
authors.initials: DE
authors.lastname: Meuffels
authors.affiliation: Orthopaedic Research Center Amsterdam, Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: C N
authors.initials: CN
authors.lastname: van Dijk
authors.affiliation: Orthopaedic Research Center Amsterdam, Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: Leendert
authors.initials: L
authors.lastname: Blankevoort
mesh_terms: D000328:Adult; D001182:Arthroscopy; D003646:Debridement; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D055909:Magnetic Field Therapy / Q000706:statistics & numerical data*; D008297:Male; D009426:Netherlands; D000068958:Return to Sport / Q000706:statistics & numerical data*; D013628:Talus / Q000002:abnormalities / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: ankle; arthroscopic debridement and microfracture; articular cartilage; biophysical stimulation; osteochondral defect; pulsed electromagnetic fields