Biophysical Stimulation in Athletes' Joint Degeneration: A Narrative Review.

Lorenzo Moretti,Francesco Moretti,Stefania Setti,Davide Bizzoca,Giuseppe Danilo Cassano,Giovanni Angelo Giancaspro,Biagio Moretti

doi:10.3390/medicina57111206

Abstract

Osteoarthritis (OA) is the most prevalent degenerative joint disease and the main cause of pain and disability in elderly people. OA currently represents a significant social health problem, since it affects 250 million individuals worldwide, mainly adults aged over 65. Although OA is a multifactorial disease, depending on both genetic and environmental factors, it is reported that joint degeneration has a higher prevalence in former athletes. Repetitive impact and loading, joint overuse and recurrent injuries followed by a rapid return to the sport might explain athletes’ predisposition to joint articular degeneration. In recent years, however, big efforts have been made to improve the prevention and management of sports injuries and to speed up the athletes’ return-to-sport. Biophysics is the study of biological processes and systems using physics-based methods or based on physical principles. Clinical biophysics has recently evolved as a medical branch that investigates the relationship between the human body and non-ionizing physical energy. A physical stimulus triggers a biological response by regulating specific intracellular pathways, thus acting as a drug. Preclinical and clinical trials have shown positive effects of biophysical stimulation on articular cartilage, subchondral bone and synovia. This review aims to assess the role of pulsed electromagnetic fields (PEMFs) and extracorporeal shockwave therapy (ESWT) in the prevention and treatment of joint degeneration in athletes.

Highlights

Athletes, due to the physical demands necessary for chasing sporting results, put significant stress on their joints and it is usual for them to suffer from articular cartilage defects
This review aims to assess the role of pulsed electromagnetic fields (PEMFs) and extracorporeal shockwave therapy (ESWT) in the prevention and treatment of joint degeneration in athletes
PEMF therapy, with the same treatment protocol in 31 patients with focal knee chondral tears who were undergoing arthroscopy with chondroabrasion and/or perforations, involved a reduction from 75% to 26% with the use of nonsteroidal anti-inflammatory drugs (NSAID), a higher KOOS at 90 days and a large number of patients that returned to normal daily sports activity at 3 years follow up [33]

Summary

Introduction

Due to the physical demands necessary for chasing sporting results, put significant stress on their joints and it is usual for them to suffer from articular cartilage defects. Chondral defects are linked to discomfort and physical weakness, the limiting of athletic activity and have been implicated as a potential risk factor in the development of early-onset osteoarthritis (OA). Chondral injuries are often present in sports subjects; the incidence rate in the knee is 36% compared to 16% in the general population [2]. Concomitant ligament instability, misalignment, and previous injury may facilitate chondral lesions. Chondral damage can lead to an excessive load on the subchondral bone and to bone edema, which can manifest itself with painful symptoms and limit sports participation

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