The role of electrical stimulation in bone regeneration: mechanistic insights and therapeutic advances

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Bone regeneration is a complex biological process that involves the coordinated action of osteoblasts, osteoclasts, and mesenchymal stem cells (MSCs). While bone possesses an intrinsic ability to heal, large defects, delayed unions, and non-unions require advanced therapeutic interventions. Electrical stimulation (ES) has emerged as a promising strategy to enhance bone healing by modulating cellular activity, promoting osteogenic differentiation, and accelerating vascularization. This review explores the mechanistic role of bioelectrical cues in bone regeneration, emphasizing the influence of voltage-gated ion channels, particularly voltage-gated calcium channels (VGCCs), in transducing electrical signals into biochemical responses. Various types of ES modalities, including direct current (DC), capacitive coupling (CC), Pulsed Electromagnetic Field (PEMF), and piezoelectric stimulation, are evaluated for their effectiveness in clinical and preclinical applications. Additionally, the synergistic potential of ES when combined with biomaterials, stem cells, and growth factors is discussed. Despite promising results, challenges remain in translating preclinical findings to clinical applications, with key hurdles including standardization of treatment protocols, variability in patient responses, and regulatory constraints. Large-animal models have provided insights into the efficacy

Evidence level

Evidence from laboratory and animal studies provides groundwork for understanding mechanisms and potential before human studies continue.

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