Guide Biophysical Bone Behavior: Principles and Applications

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Behari develops a bridge between the physics and biology of bone leading to its clinical applications, primarily electro stimulations in fracture healing and osteoporosis. The book is based upon the author's own research work and his review articles in the area, updated with the latest research results. Helps readers understand the behavior of bone under electrical stimulation from both fundamental and clinical aspects Develops the relationship between the biophysics and biology of bone into an integral unit Spans basic biophysical studies and clinical applications Links the various topics together to give readers a holistic understanding of the area Presents all major research findings about bone and biophysics Biophysical Bone Behavior is intended for a wide variety of readers, including applied biologists or physical scientists and engineers with research interests in medical applications: biomaterials scientists and designers, bone tissue engineers, biophysicists, and biomechanists.

Orthopedic surgeons, endocrinologists, radiologists, and physical rehabilitation practitioners will benefit from the clinical aspects and the underlying fundamentals Behari presents in the book. His main research interests are in the area of bioelectromagnetics, with emphasis on applications of microwaves and solid state physics techniques in environmental sciences, which includes soil moisture measurement. He has generated over one hundred research publications, four patents, and has developed several instruments in the electromagnetic field.

He has in the past received Fulbright and University Grant Commission fellowships. Behari holds a PhD in Physics and was conferred an honorary D. Biophysical Bone Behaviour: Principles and Applications is the culmination of efforts to relate the biophysical phenomena in bone to bone growth and electrical behavior. IKDC and Lysholm and constant scores were significantly improved in both groups with no significant intergroup differences.

Today, numerous other areas of medicine are preparing to use physical means to treat a variety of conditions or are seeing its potential. Some applications are in their infancy or are still at the stage of in vitro experimentation; however, current evidence seems to suggest that these treatment approaches will become increasingly widespread, for example in the treatment of tendinopathies or in neurology. The effects of PEMFs, in fact, have recently been studied on primary human cells isolated from semitendinosus and gracilis tendons exposed to PEMFs: results show that PEMFs do not alter cell vitality or induce apoptotic phenomena but are able to induce responses at gene expression level and to reduce the production of inflammatory cytokines in the tendon cells [ 67 ].

In MSCs isolated from the human umbilical cord and seeded in tendon differentiation medium, PEMF showed a greater production of collagen type I, scleraxis and greatest expression of tenogenic markers [ 68 ].


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In neurology, there is great interest in the development of novel therapies for acute ischaemic stroke because thrombolysis is the only approved treatment. PEMFs could represent an alternative approach because of their effects on the main mechanisms of brain ischaemia. Capone et al. Recently, a small, open-label, one-arm, exploratory study to evaluate the safety of PEMF stimulation in acute ischemic stroke clinicaltrials.

Biophysical stimulation is the result of solid scientific research.

Biophysical Bone Behaviour : Principles and Applications by Jitendra Behari (2009, Hardcover)

As reported in by Yuan et al. Moreover, the promotion effect has shown strikingly positive benefits in the treatment of various skeletal diseases. In the USA and Europe, research on the use of physical energy for bone repair processes has been ongoing throughout the past century. Every year, tens of thousands of patients undergo treatment all over the world. Recently, Iwasa et al. The authors concluded that PEMF has a beneficial effect on chondrocyte proliferation, matrix synthesis and chondrogenic differentiation by upregulation of TGF-b and BMPs, and it decreases anti-inflammatory cytokines via A 2A and A 3 adenosine receptors leading in clinical translational investigations, a beneficial effect on pain and functions of OA knees.

The orthopaedic community has undoubtedly played a central role in the development and understanding of the importance of physical stimuli to control biological activities. Orthopaedic research has demonstrated that the effects are dependent on physical parameters and, mediating from pharmacology, has introduced the concept of physical dynamics. Biophysical treatment appears to be effective for the prolonged treatment of chronic degenerative conditions, while it does not seem suited to treating systemic diseases. An important aspect of treatment with physical agents is the ability to transfer the effects observed in basic research to clinical practice.

Further development of the clinical use of physical agents involves overcoming numerous and complex hurdles; however, the ability to recognise and define an area with the potential for new treatment approaches, such as clinical biophysics, is a fundamental step in pointing the way for future research in various sectors. This article does not contain any studies with human participants or animals performed by any of the authors. Skip to main content Skip to sections.

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First Online: 15 January Introduction Biophysical stimulation is a non-invasive therapy used in orthopaedic practice to increase and enhance reparative and anabolic activities of tissue. Methods A sistematic web-based search for papers was conducted using the following titles: 1 pulsed electromagnetic field PEMF , capacitively coupled electrical field CCEF , low intensity pulsed ultrasound system LIPUS and biophysical stimulation; 2 bone cells, bone tissue, fracture, non-union, prosthesis and vertebral fracture; and 3 chondrocyte, synoviocytes, joint chondroprotection, arthroscopy and knee arthroplasty.

Results Pre-clinical studies have shown that the site of interaction of biophysical stimuli is the cell membrane. Discussion The pooled result of the studies in this review revealed the efficacy of biophysical stimulation for bone healing and joint chondroprotection based on proven methodological quality.

Biophysical Bone Behavior Principles And Applications 2009

Conclusion The orthopaedic community has played a central role in the development and understanding of the importance of the physical stimuli. Biophysical stimulation techniques can be used in clinical medicine, either alone, to increase and promote the repair and anabolic activity in tissue, or in association with drug treatment, to strengthen its activity and lessen side effects. Clinical biophysics is an interdisciplinary science which: Uses methods and theories from the field of physics to study biological systems Studies how non-ionising physical stimuli interact with biological systems.

Underlying the new pharmacology is the need to identify the effects of the physical agents in terms of how these modulate a particular cell function, which will then form the basis of its clinical application. The cell membrane has been identified as a target and site of interaction, through which the physical signal activates a cascade of intracellular events; the transduction pathways have been seen to differ depending on the type of energy used Fig. Each time a physical agent is able to modulate a cell activity, the effect observed will be function-specific, rather than cell- or tissue-specific.

This allows all conditions which are positively influenced by the activation or modulation of this cell function to be treated with the same physical agent. Open image in new window. The key principles of biophysical stimulation are as follows: 1. The ability of the physical stimulus to act selectively on cell targets. Identification of the dose-response effects.

Effects of biophysical stimulation on bone cells Numerous studies have analysed the effects of biophysical stimulation on osteoblast proliferation and have highlighted a dose-response effect for exposure times, PEMF intensity, frequencies and signal waveforms [ 1 , 2 ] Fig. More specifically, Brighton et al. In human osteosarcoma cell lines and osteoblast cells in vitro, De Mattei et al. Leung et al. Total number of live cells, cell proliferation, alkaline phosphatase activity, osteocalcin secretion and expression of vascular endothelial growth factors were evaluated.

Similar to that reported for the proliferative effects, in vitro studies have shown that in various cell models, biophysical stimulation induces i an increase in osteoblast differentiation, promoting the production of collagen and of the main matrix glycoproteins osteocalcin and osteopontin [ 6 , 7 ]; ii stimulates the mineralisation process [ 8 , 9 ]; and iii plays an inhibitory role in the process of osteoclast differentiation and exerts a protective action against osteolysis [ 10 ].

Ebook Biophysical Bone Behavior: Principles And Applications

Table 1 Biophysical stimulation on the regulation of bone matrix and growth factors. In bovine chondrocytes and synoviocytes [ 13 , 14 ], A 2A and A 3 adenosine receptors, endogenous modulator of many biological processes such as inflammation, increased in number in the presence of PEMFs, reducing the release of PGE 2 , IL-6, IL-8 and COX-2, a result which suggests a reduction in the inflammatory state and in the degradation of cartilage associated with articular diseases. Human synoviocytes treated with PEMFs reveal a significant increase in A 2A and A 3 adenosine receptors, as demonstrated by the mRNA, Western blotting analysis and saturation binding experiments involving ARs, as well as a significant increase in the release of IL, a known anti-inflammatory cytokine [ 15 ].

PEMFs have been shown to affect the increase of human articular chondrocyte proliferation, based on exposure time, intensity and frequency [ 17 ]. It should be stressed that the effect of PEMFs on proteoglycan synthesis in human cartilage explants is comparable in all senses to that induced by growth factor IGF-I, the principal cartilage anabolic factor [ 18 , 19 ]. It is interesting to observe that these results regarding the anti-inflammatory role of PEMFs are also confirmed in the stem cell cultures [ 21 ]. Table 2 Pulsed electromagnetic field effect in articular cells. Effects of biophysical stimulation on bone repair There are numerous studies in literature, performed in animal models as early as the s, which attest to the osteogenic effects of biophysical stimulation in bone repair.

In a study on dogs, Bassett et al. De Haas et al. In , Midura et al. In a study involving a rabbit fibular osteotomy model, Brighton et al. In , Rijal et al. A series of in vivo studies followed in the s, giving a better understanding of the ultrasound signal characteristics and treatment times able to accelerate the bone healing process in fractures. Osteotomy The first studies on the effect of biophysical stimulation recognised as having level of evidence I status were three in number and were conducted by the Italian orthopaedic community as early as the s, on patients undergoing osteotomy of the lower limbs.

The studies report a significant increase in the density of the trabecular bone callus in the active group compared to the placebo group [ 33 ], a higher consolidation success rate [ 34 ] and a shortening of consolidation time by three months [ 35 ] Fig. Table 3 Summary of main clinical studies using pulsed electromagnetic field therapy in non-unions. A few years later, Linovitz et al.

Beneficial effects on pain control and a reduced use of nonsteroidal anti-inflammatory drug NSAIDs are also described in literature. Rossini et al. Massari [ 53 ] and Piazzolla et al. Santori et al. The book is based upon authors own research work and his review articles in the area, and updated with the latest research results.

The first book dedicated to biophysical bone behavior Develops the relationship between the biophysics and biology of bone into an integral unit Spans basic biophysical studies and clinical applications Links the various topics together to give readers a holistic understanding of the area Presents all major research findings about bone and biophysics. Additional Product Features Dewey Edition. Show More Show Less. No ratings or reviews yet. Be the first to write a review. Best Selling in Nonfiction See all. Open Borders Inc.

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