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Objective: To investigate the bionic pulsed electromagnetic fields on the role of avascular necrosis. Methods: In this study, rabbit horse serum injections cause allergic vasculitis, combined glucocorticoid-induced osteonecrosis animal model preparation method, ie experimental adult rabbits, ear vein injection of sterile inactivated horse serum, 10ml/kg / times, a total of two, spaced three weeks; intraperitoneal injection of methylprednisolone (Methylpoednisolone, MP) 40mg/kg / day for three consecutive days after the last injection MP successfully established after 8 weeks of hormone-type avascular necrosis of the model. In this study by the Chinese Academy of Medical Sciences Institute of Biomedical Engineering developed bionic pulsed electromagnetic field therapy device, the basic parameters are as follows: spike waveform decay waveform; pulsed magnetic field frequency is 2 ~ 20Hz; maximum magnetic field strength of 10mT: signal power spectrum 0 ~ 250Hz, the main power band of 2 ~ 75Hz. Experimental animals 40 randomly selected 10 as the control group (D), does not give any treatment, and the remaining 30 were randomly divided into two groups (A, B) of 15. A group of modeling electromagnetic fields while giving preventive treatment, one hour each day; B group preventive treatment control group, given the modeling process. Each group at 8 weeks after modeling all the blood and sacrificed sequentially blood biochemistry, pathology, radioimmunoassay and other tests. Electromagnetic pulse through animal experiments the therapeutic effect of treatment was started after clinical trials. In the selection of avascular necrosis of orthopedic clinic patients, the main choice in patients with femoral head collapse before, the extent of damage that does not exceed by ARCO grading stage Ⅲ b, 16 cases treated subjects, mean age 54 years (44 to 67 years), mean a history of 10 years (3 to 20 years). Necrosis after 12 cases of steroid use, post-traumatic necrosis in two cases. One hour a day to give pulse electromagnetic treatment of femoral head necrosis. Through the patient's Harris scores and ARCO classification changes before and after treatment were observed pulsed electromagnetic therapy device for avascular necrosis of the clinical effect. Results: 1. Blood biochemical outcomes: A, B, plasma fibrinogen concentration was significantly higher than the control group (1.99 ± 0.60g / 1), the independent sample t test was statistically significant; each group without plasma alkaline phosphatase statistical difference. 2 Histopathology showed that the treatment group trabecular thinning, thinning, structural disorder, part of the fracture; bone karyopyknosis, stained; decrease in bone marrow hematopoietic tissue, fat tissue increased; empty lacunae increased (average 32.2%). Treated trabecular thickening and dense structure rules; surface new bone formation; bone marrow hematopoietic tissue increased; adipose tissue reduction, empty lacunae rate decreased (21.7%, 30.2%), but still higher than the blank control groups. Blank control group showed normal bone pathological structure, empty lacunae rate of about 16.3 percent, the number of blank group subchondral vessels than the other groups (28.6 ± 3.7 reviews), other groups no significant difference in the number of blood vessels (A: 18.9 ± 4.7 , B: 15.2 ± 4.7 reviews). 3 electromagnetic treatment group and the control group PPARγ treatment was significantly higher than the control group, the independent samples t-test was statistically significant. Electromagnetic field therapy treatment group PPARγ than the control group, independent samples t-test was statistically significant. Treatment outcome mainly for the original effective pain relief. After a minimum of 12 months of treatment in 13 patients pain symptoms significantly reduced, Harris score improved in all patients no symptoms. 16 patients, 8 were excellent in 5 cases of benign and three cases of obvious symptoms change. Hip function and scope of activities has not changed, ARCO classification did not change, 2 patients MRI imaging findings necrotic area smaller than before. Conclusions: 1. Lot of glucocorticoids can cause the application of plasma fibrinogen concentration in the blood is hypercoagulable state. (2) early osteonecrosis, bone cells PPARγ namely increased, while the pathological changes found in bone marrow cells of fat, bone marrow fat necrosis of the femoral head is pathogenesis; 3. Bionics pulsed electromagnetic fields generated can be reduced PPARγ, pathology results improvement in bone marrow cells of fat, empty lacunae was significantly reduced, the bone marrow to increase the number of blood vessels. A certain degree of control over Hormone avascular necrosis of the occurrence and development, so BEMFs for the treatment of ischemic necrosis of the femoral head is an effective treatment; 4. Bionic pulsed electromagnetic fields for the clinical treatment of patients with osteonecrosis effect mainly for pain mitigation, restoration patient quality of life, slow the progression.
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