ABSTRACT
This chapter reviews the best-available clinical evidence for the use of electrical stimulation in bone healing. Electrical stimulation has been shown to be an effective and noninvasive method for enhancing bone healing and treating fracture nonunions in the clinical setting. Typically, electrical stimulation can be applied using direct current (DC), capacitive coupling (CC), and inductive coupling (IC) to improve bone healing. Bone healing is a multistage process that is highly orchestrated in response to injury. The immediate inflammatory response leads to the recruitment of stem cells and their differentiation into chondrocytes to produce cartilage and osteoblasts to form bone. Electrical signals have been shown to play an instructive role in many cell behaviors, affecting the cell proliferation, differentiation, and migration. Today electrical stimulators are often classified into electromagnetic or ultrasound. More recently, low-intensity pulsed ultrasound (LIPUS) has also become popular, which is a noninvasive method of treatment.
