US20090062885A1 - Method and device for treating osteoarthritis and cartilage disease, defects, and injuries in the human hip - Google Patents

Method and device for treating osteoarthritis and cartilage disease, defects, and injuries in the human hip Download PDF

Info

Publication number
US20090062885A1
US20090062885A1 US10/579,174 US57917404A US2009062885A1 US 20090062885 A1 US20090062885 A1 US 20090062885A1 US 57917404 A US57917404 A US 57917404A US 2009062885 A1 US2009062885 A1 US 2009062885A1
Authority
US
United States
Prior art keywords
current
human
hip joint
voltage
hip
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Abandoned
Application number
US10/579,174
Inventor
Carl T. Brighton
Solomon R. Pollack
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
University of Pennsylvania Penn
Original Assignee
University of Pennsylvania Penn
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by University of Pennsylvania Penn filed Critical University of Pennsylvania Penn
Assigned to THE TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA reassignment THE TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: POLLACK, SOLOMON R, BRIGHTON, CARL T
Publication of US20090062885A1 publication Critical patent/US20090062885A1/en
Abandoned legal-status Critical Current

Links

Images

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/18Applying electric currents by contact electrodes
    • A61N1/32Applying electric currents by contact electrodes alternating or intermittent currents
    • A61N1/326Applying electric currents by contact electrodes alternating or intermittent currents for promoting growth of cells, e.g. bone cells
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61NELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
    • A61N1/00Electrotherapy; Circuits therefor
    • A61N1/40Applying electric fields by inductive or capacitive coupling ; Applying radio-frequency signals

Definitions

  • the present invention is directed to a method of determining the voltage and current output required for the application of specific and selective electric and electromagnetic signals to diseased articular cartilage the treatment of osteoarthritis, cartilage defects due to trauma or sports injuries, or as an adjunct with other therapies (e.g., cell transplantation, tissue-engineered scaffolds, growth factors, etc.) for treating cartilage defects in the human hip joint and a device for delivering such signals to a patient's hip.
  • therapies e.g., cell transplantation, tissue-engineered scaffolds, growth factors, etc.
  • Osteoarthritis also known as degenerative joint disease, is characterized by degeneration of articular cartilage as well as proliferation and remodeling of subchondral bone. The usual symptoms are stiffness, limitation of motion, and pain. Osteoarthritis is the most common form of arthritis, and prevalence rates increase markedly with age. It has been shown that elderly patients with self-reported osteoarthritis visit doctors twice as frequently as their unaffected peers. Such patients also experience more days of restricted activity and bed confinement compared to others in their age group. In one study, the majority of symptomatic patients became significantly disabled during an 8-year follow-up period (Massardo et al., Ann Rheum Dis 48:893-897, 1989).
  • Nonsteroidal anti-inflammatory drugs remain the primary treatment modality for osteoarthritis. It is unknown whether the efficacy of NSAIDs is dependent upon their analgesic or anti-inflammatory properties or the slowing of degenerative processes in the cartilage. There is also a concern that NSAIDs may be deleterious to patients. For example, NSAIDs display well-known toxic effects in the stomach, gastrointestinal tract, liver and kidney. Moreover, aspirin inhibits proteoglycan synthesis and normal cartilaginous repair processes in animals. One study in humans also suggested that indomethacin might accelerate breakdown of hip cartilage. All adverse effects appear more commonly in the elderly—the very population most susceptible to osteoarthritis.
  • Bone demineralizes and becomes abnormally rarefied.
  • Bone comprises an organic component of cells and matrix as well as an inorganic or mineral component.
  • the cells and matrix comprise a framework of collagenous fibers that is impregnated with the mineral component of calcium phosphate (85%) and calcium carbonate (10%) that imparts rigidity to bone.
  • calcium phosphate 85%
  • calcium carbonate 85%
  • osteoporosis is generally thought to afflict the elderly, certain types of osteoporosis may affect persons of all ages whose bones are not subject to functional stress. In such cases, patients may experience a significant loss of cortical and cancellous bone during prolonged periods of immobilization.
  • PEMFs Pulsed electromagnetic fields
  • CC capacitive coupling
  • the present invention related to treating osteoarthritis and other cartilage diseases, defects, and injuries in human hip joints via the application of specific and selective fields generated by specific and selective electric and/or electromagnetic signals.
  • the invention includes a method of determining the voltage and current of the signal to apply to electrodes or to a solenoid or to at least one coil applied to the hip for treatment.
  • the invention relates to a method of treating diseased tissue in a human through the application of a specific and selective electric or electromagnetic field to diseased tissue in a human, including osteoarthritis and other cartilage diseases, defects and injuries in the hip, or used as an adjunct with other therapies (cell transplantation, tissue-engineered scaffolds, growth factors, etc.) in treating cartilage defects in the human hip.
  • the method includes the steps of determining the voltage and current output that produces the desired 20 mV/cm electric field in the articular cartilage of the human hip joint, and other voltage and current values for other effective electric field amplitudes thought or known to be effective.
  • the method includes constructing an anatomic model of the human hip joint and translating the anatomic model to an analytical model of the hip in which the dimensions for the tissues encountered from skin (anterior) through fat and skin (posterior) are determined. Planar circuits were then constructed in which the various tissue conductivities, impedances and current flow were used in calculating the voltage and current required to be applied to surface electrodes placed anteriorly and posteriorly on the skin covering the hip in order to produce an electric field at 20 mV/cm in articular cartilage of the hip joint at a frequency of 60 kHz.
  • One knowledgeable in the field could perform the same analysis at other frequencies, adjust the tissue impedances to their values at the new frequency and obtain different values for the ranges of the electrical field and current density at any chosen frequency or set of frequencies.
  • the invention also includes a method and a device for treating diseased tissue (such as osteoarthritis), defective or injured tissue in a human hip joint through the application of a specific and selective electric or electromagnetic field to the afflicted tissue in the human hip joint.
  • a device in accordance with a capacitive coupling embodiment of the invention includes at least two electrodes adapted for application in the proximity of a patient's hip joint and a signal generator that generates electric signals for application to the electrodes so as to produce an electric field of amplitude of 20 mV/cm ⁇ 15% and a current density of 120 ⁇ A/cm 2 ⁇ 15% within the synovium and articular cartilage of the patient's hip joint.
  • An inductive coupling embodiment of the invention includes a coil(s) or solenoid adapted and configured to receive the electric signals to produce these electric fields.
  • the signal generator provides one of a plurality of output electric signals with a voltage selected by a user in accordance with a size of the human hip joint. Larger hip joints receive signals of larger voltages.
  • FIG. 1 illustrates an anatomic model of the human hip joint showing all the important tissues and structures through which the current passes between the anterior and posterior surface electrodes placed on skin.
  • FIG. 2 illustrates an analytical model of the human hip joint from which size parameters are determined for each of the tissues and structures indicated.
  • FIG. 3A illustrates a planar circuit model of the human hip joint showing circumferential flow of current through the fat layers (I 3 ) plus leakage flow of current through the muscle and other soft tissue (I 4 ), plus current flow across the hip joint (I 2 ) and the impedance (Z) compartments.
  • FIG. 3B illustrates a planar circuit showing in detail the current flow and impedances across the hip joint (Z T1 ).
  • FIG. 4 illustrates schematically the three currents that were calculated in determining the output current and voltage required to produce a 20 mV/cm field in the articular cartilage of the hip joint.
  • the three currents are the circumferential current, the leakage current, and the current flowing through the hip joint.
  • FIG. 5 illustrates electrode placement on the skin that is required to produce the desired electric field in the hip joint.
  • signal is used to refer to a variety of signals including mechanical signals, ultrasound signals, electromagnetic signals, and electric signals outputted by a device.
  • field refers to an electric field within a targeted tissue, whether it is a combined field or a pulsed electromagnetic field, or generated by direct current, capacitive coupling, or inductive coupling.
  • the typical human hip joint includes layers of cartilage and synovial fluid that is bounded by the acetabulum and the femoral head.
  • osteoarthritis, cartilage disease, defects and injuries in the hip joint is treated by the application of specific and selective electric fields via electrodes 10 , 20 attached relative to the hip joint substantially as shown in FIG. 1 .
  • a signal generator 30 provides the appropriate signals to the electrodes for generating the specific and selective electric fields.
  • the specific and selective electric field needed to treat osteoarthritis, cartilage disease, defects and injuries in the hip joint is calculated in accordance with the invention using the analytical model of the hip joint depicted in FIG. 2 .
  • FIG. 1 illustrates an anatomical model for use in determining the electric field amplitude and current density obtained in the cartilage space in a hip joint when electrodes 10 , 20 are placed anteriorly and posteriorly, respectively, and a voltage is applied causing a current to flow through the body.
  • electrodes 10 , 20 the following elements are identified as indicated: electrodes 10 , 20 , skin 40 , fat 50 , muscle 60 , bone (acetabulum) 70 , cartilage and synovial fluid 80 , and femoral head 90 .
  • the frequency of a sine wave voltage is taken to be 60 kHz; however, the methodology described herein can be applied to any frequency as long as the electrical properties of the tissues are chosen for those frequencies.
  • the electrodes 10 , 20 are assumed to be 2′′ ⁇ 2′′ square and the currents are calculated by considering the current flow through the patient's body for a 2′′ ⁇ 2′′ rectangle from one electrode to the other plus the circumferential flow of current through the fat layer plus the leakage current that flows through the muscle and other soft tissues outside of the 2′′ ⁇ 2′′ rectangle but excluding the circumferential current in the fat layer. These currents are shown in FIGS. 3 and 4 .
  • the impedances of the tissue compartments through which the current I 2 ( FIG. 3 ) flows are shown in FIG. 3B .
  • a line drawing showing patient electrode placement is presented in FIG. 5 .
  • the region in broken lines is modeled as a 2′′ ⁇ 2′′ rectangle 100 in which the body current is assumed to flow.
  • Leakage currents as shown in FIGS. 3A and 4 include circumferential flow in the fat layer and body currents outside of the 2′′ ⁇ 2′′ rectangle 100 .
  • the current flow and impedance through region 100 are those shown in FIG. 3B
  • FIGS. 2 , 3 A, 3 B and 4 are shown below in Table 2. Each impedance labeled in FIGS. 3 and 4 was calculated using the relationship:
  • Length is the dimension of the tissue in the direction of the current flow
  • Area is the cross-sectional area of the tissue perpendicular to the direction of current flow
  • a is the electrical conductivity
  • the impedances were then calculated using Equation 1, the dimensions in Table 1A and the conductivities in Table 1B.
  • the total current, I 1 ( FIG. 3A ) that must flow from the electrodes was calculated for each patient classification for a voltage applied to the electrodes.
  • I 2 the current flow through the muscle-femur-cartilage-muscle layers;
  • I 3 the current flowing circumferentially through the fat layer and
  • I 4 the leakage currents
  • the current density value at the electrodes 2.02 mA/cm 2 , is at the maximum value and should not be exceeded.
  • Electrodes may have tissue compartment sizes and/or skin impedance values that differ from those modeled here. Therefore, devices that power the electrodes should have output variability to increase the peak-to-peak voltage to achieve the desired electrode current (density).
  • the current (or electric field) that flows through the cartilage of the hip when a voltage is applied to the electrodes on the skin is determined by the impedances shown in FIGS. 3A and 3B .
  • the dimensions of various tissue compartments can vary so that the current that actually flows through the cartilage could be higher or lower than the values shown for an applied device voltage as shown above.
  • the cartilage current (and therefore the cartilage electric field) could differ by ⁇ 15%. Therefore, in order to account for this variation, and to account for the variation of skin electrical impedance from patient to patient, the device should be designed to apply the device current value plus or minus 15% to the pair of 2′′ ⁇ 2′′ electrodes 10 , 20 .
  • the approximate size of the patient's hip is determined, and a signal is generated and applied to the electrodes that will generate the desired electric field with a voltage of 20 mV/cm ⁇ 15% and a current density of 120 ⁇ A/cm 2 ⁇ 15% within the synovium and articular cartilage for treatment of osteoarthritis in the hip, for example.
  • the signal generator includes a select control ( FIG. 1 ) that allows the operator to select the proper output based on the size of the patient's hip.

Abstract

A method of determining the voltage and current required for the application of specific and selective electric and electromagnetic signals to diseased articular cartilage in the treatment of osteoarthritis, cartilage defects due to trauma or sports injury, or used as an adjunct with other therapies (cell transplantation, tissue-engineered scaffold, growth factors, etc.) for treating cartilage defects in the human hip joint and a device for delivering such signals to a patient's hip. Anatomic, analytical, and planar circuit models are developed to determining the impedances, conductivities, and current flows in the human hip joint and its surrounding soft tissues and skin that are required to produce a 20 mV/cm electric field in the synovium and articular cartilage of the human hip. The voltage of the signal applied to the surface electrodes or to a coil(s) or solenoid is varied based on the size of the hip joint; larger hip joints require larger voltages to generate the effective electric field.

Description

    CROSS-REFERENCE TO RELATED APPLICATIONS
  • The present patent application claims priority to U.S. Provisional Patent Application Nos. 60/520,088 filed Nov. 14, 2003 and 60/535,734 filed Jan. 9, 2004. The present patent application also claims priority to U.S. patent application Ser. No. 10/257,126, filed Oct. 8, 2002, entitled “Regulation of Genes Via Application of Specific and Selective Electrical and Electromagnetic Signals”, which claims priority to PCT/US01/05991 filed Feb. 23, 2001, and U.S. Provisional Application No. 60/184,491 filed Feb. 23, 2000, and U.S. patent application Ser. No. 10/255,241, filed Sep. 26, 2002, entitled “Regulation of Aggrecan Gene Expression with a Specific and Selective Electrical Signal”, Ser. No. 10/267,708, filed Oct. 9, 2002, entitled “Regulation of Type II Collagen Gene Expression with a Specific and Selective Electrical Signal”, Ser. No. 10/457,167, filed Jun. 9, 2003, entitled “Method and Apparatus for Treating Osteoarthritis, Cartilage Disease, Defects and Injuries in the Human Knee Joint,” Ser. No. 10/461,188, filed Jun. 13, 2003, entitled “Regulation of Matrix Metalloproteinase Gene Expression Using Specific and Selective Electrical and Electromagnetic Signals,” and Ser. No. 10/603,226, filed Jun. 25, 2003, entitled “Portable Electrotherapy Device for Treating Osteoarthritis and Other Diseases, Defects and Injuries of the Knee Joint.” The contents of all of these applications are hereby incorporated by reference in their entireties.
  • FIELD OF THE INVENTION
  • The present invention is directed to a method of determining the voltage and current output required for the application of specific and selective electric and electromagnetic signals to diseased articular cartilage the treatment of osteoarthritis, cartilage defects due to trauma or sports injuries, or as an adjunct with other therapies (e.g., cell transplantation, tissue-engineered scaffolds, growth factors, etc.) for treating cartilage defects in the human hip joint and a device for delivering such signals to a patient's hip.
  • BACKGROUND OF THE INVENTION
  • The bioelectrical interactions and activity believed to be present in a variety of biological tissues and cells are one of the least understood of the physiological processes. However, there has recently been much research into these interactions and activities related to the growth and repair of certain tissues and cells. In particular, there has been considerable interest in stimulation by electric and electromagnetic fields and their effect on the growth and repair of bone and cartilage. Scientists believe that such research might be useful in the development of new treatments for a variety of medical problems.
  • Osteoarthritis, also known as degenerative joint disease, is characterized by degeneration of articular cartilage as well as proliferation and remodeling of subchondral bone. The usual symptoms are stiffness, limitation of motion, and pain. Osteoarthritis is the most common form of arthritis, and prevalence rates increase markedly with age. It has been shown that elderly patients with self-reported osteoarthritis visit doctors twice as frequently as their unaffected peers. Such patients also experience more days of restricted activity and bed confinement compared to others in their age group. In one study, the majority of symptomatic patients became significantly disabled during an 8-year follow-up period (Massardo et al., Ann Rheum Dis 48:893-897, 1989).
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) remain the primary treatment modality for osteoarthritis. It is unknown whether the efficacy of NSAIDs is dependent upon their analgesic or anti-inflammatory properties or the slowing of degenerative processes in the cartilage. There is also a concern that NSAIDs may be deleterious to patients. For example, NSAIDs display well-known toxic effects in the stomach, gastrointestinal tract, liver and kidney. Moreover, aspirin inhibits proteoglycan synthesis and normal cartilaginous repair processes in animals. One study in humans also suggested that indomethacin might accelerate breakdown of hip cartilage. All adverse effects appear more commonly in the elderly—the very population most susceptible to osteoarthritis.
  • In the disease commonly known as osteoporosis, bone demineralizes and becomes abnormally rarefied. Bone comprises an organic component of cells and matrix as well as an inorganic or mineral component. The cells and matrix comprise a framework of collagenous fibers that is impregnated with the mineral component of calcium phosphate (85%) and calcium carbonate (10%) that imparts rigidity to bone. While osteoporosis is generally thought to afflict the elderly, certain types of osteoporosis may affect persons of all ages whose bones are not subject to functional stress. In such cases, patients may experience a significant loss of cortical and cancellous bone during prolonged periods of immobilization. Elderly patients are known to experience bone loss due to disuse when immobilized after fracture of a bone; this may ultimately lead to a secondary fracture in an already osteoporotic skeleton. Diminished bone density may lead to collapse of vertebrae, fractures of hips, lower arms, wrists and ankles, as well as incapacitating pains. Alternative non-surgical therapies for such diseases are needed.
  • Pulsed electromagnetic fields (PEMFs) and capacitive coupling (CC) have been used widely to treat non-healing fractures and related problems in bone healing since approval by the Food and Drug Administration in 1979. The original basis for the trial of this form of therapy was the observation that physical stress on bone causes the appearance of tiny electric currents that, along with mechanical strain, were thought to be the mechanisms underlying transduction of the physical stress into a signal that promotes bone formation. Along with direct electric field stimulation that was successful in the treatment of nonunion bone fractures, noninvasive technologies using PEMF and CC (where the electrodes are placed on the skin in the treatment zone) were also found to be effective. PEMFs generate small, induced currents (Faraday currents) in the highly conductive extracellular fluid, while CC directly causes currents in the tissues; both PEMFs and CC thereby mimic endogenous electrical currents.
  • The endogenous electrical currents, originally thought to be due to phenomena occurring at the surface of crystals in the bone, have been shown to be due primarily to movement of fluid containing electrolytes in channels of the bone containing organic constituents with fixed negative charges, generating what are called “streaming potentials.” Studies of electrical phenomena in cartilage have demonstrated a mechanical-electrical transduction mechanism that resembles those described in bone, appearing when cartilage is mechanically compressed, causing movement of fluid and electrolytes over the surface of fixed negative charges in the proteoglycans and collagen in the cartilage matrix. These streaming potentials apparently serve a purpose in cartilage similar to that in bone, and, along with mechanical strain, lead to signal transduction that is capable of stimulating chondrocyte synthesis of matrix components.
  • The main application of direct current, CC, and PEMFs has been in orthopaedics in the healing of nonunion bone fractures (Brighton et al. J Bone Joint Surg 1981; 63:2-13; Brighton and Pollack J Bone Joint Surg 1985; 67:577-585; Bassett et al. Crit Rev Biomed Eng 1989; 17:451-529; Bassett et al. J Am Med Assoc 1982; 247:623-628). Clinical responses have been reported in avascular necrosis of hips in adults and Legg-Perthe's disease in children (Bassett et al. Clin Orthop 1989; 246:172-176; Aaron et al. Clin Orthop 1989; 249:209-218; Harrison et al. J Pediatr Orthop 1984; 4:579-584, 1984). It has also been shown that PEMFs (Mooney. Spine 1990; 15:708-712) and CC (Goodwin et al. Spine 1999; 24:1349-135) can significantly increase the success rate of lumbar fusions. There are also reports of augmentation of peripheral nerve regeneration and function and promotions of angiogenesis (Bassett. Bioessays 1987; 6:36-42). Patients with persistent rotator cuff tendonitis refractory to steroid injection and other conventional measures showed significant benefit compared with placebo treated patients (Binder et al. Lancet 1984; 695-698). Finally, Brighton et al., have shown in rats the ability of an appropriate CC electric field to both prevent and reverse vertebral osteoporosis in the lumbar spine (Brighton et al. J Orthop Res 1988; 6:676-684; Brighton et al. J Bone Joint Surg 1989; 71:228-236).
  • More recently, research in this area has focused on the effects that stimulation has on tissues and cells. For example, it has been conjectured that direct currents do not penetrate cellular membranes and that control is achieved via extracellular matrix differentiation (Grodzinsky Crit Rev Biomed Eng 1983; 9:133). In contrast to direct currents, it has been reported that PEMFs can penetrate cell membranes and either stimulate them or directly affect intracellular organelles. An examination of the effect of PEMFs on extracellular matrices and in vivo endochondral ossification found increased synthesis of cartilage molecules and maturation of bone trabeculae (Aaron et al. J Bone Miner Res 1998; 4:227-233). More recently, it was reported (Lorich et al. Clin Orthop Related Res 1998; 350:246-256) that signal transduction of a capacitively coupled electric signal is via voltage-gated calcium channels, leading to an increase in cytosolic calcium with a subsequent increase in activated (cytoskeletal) calmodulin.
  • Much research has been performed using tissue culture techniques in order to understand the mechanisms of response. In one study, it was found that electric fields increased [3H]thymidine incorporation into the DNA of chondrocytes, supporting the notion that Na+ and Ca+2 fluxes generated by electrical stimulation trigger DNA synthesis (Rodan et al. Science 1978; 199:690-692). Studies have found changes in the second messenger, cAMP, and cytoskeletal rearrangements due to electrical perturbations (Ryaby et al. Trans BRAGS 1986; 6; Jones et al. Trans. BRAGS 6:51, 1986; Brighton and Townsend J Orthop Res 1988; 6:552-558). Other studies have found effects on glycosaminoglycan, sulfation, hyaluronic acid, lysozyme activity and polypeptide sequences (Norton et al. J Orthop Res 1988; 6:685-689; Goodman et al. Proc Natl Acad Sci 1988; 85:3928-3932).
  • It was reported in 1996 by one of the present inventors that a cyclic, biaxial 0.17% mechanical strain produces a significant increase in TGF-β1 mRNA in cultured MC3T3-E1 bone cells (Zhuang et al. Biochem Biophys Res Commun 1996; 229:449-453). Several significant studies followed in 1997. In one study it was reported that the same cyclic, biaxial 0.17% mechanical strain produced a significant increase in PDGF-A mRNA in similar bone cells (Wang et al. Biochem Mol Biol Int 1997; 43:339-346). It was also reported that a 60 kHz capacitively coupled electric field of 20 mV/cm produced a significant increase in TGF-β1 mRNA in similar bone cells (Zhuang et al. Biochem Biophys Res Commun 1997; 237:225-229). However, the effect such a field would have on other genes has not been reported in the literature.
  • In the above-referenced parent patent application, entitled “Regulation of Genes Via Application of Specific and Selective Electrical and Electromagnetic Signals,” methods were disclosed for determining the specific and selective electrical and electromagnetic signals for use in creating specific and selective fields for regulating target genes of diseased or injured tissues. The present invention builds upon the technique described therein by describing the method of determining the voltage and current output required, and the corresponding apparatus for delivering specific and selective electrical and electromagnetic signals to the human hip joints in patients afflicted with osteoarthritis and other cartilage defects, diseases and injuries.
  • SUMMARY OF THE INVENTION
  • The present invention related to treating osteoarthritis and other cartilage diseases, defects, and injuries in human hip joints via the application of specific and selective fields generated by specific and selective electric and/or electromagnetic signals. The invention includes a method of determining the voltage and current of the signal to apply to electrodes or to a solenoid or to at least one coil applied to the hip for treatment.
  • More particularly, the invention relates to a method of treating diseased tissue in a human through the application of a specific and selective electric or electromagnetic field to diseased tissue in a human, including osteoarthritis and other cartilage diseases, defects and injuries in the hip, or used as an adjunct with other therapies (cell transplantation, tissue-engineered scaffolds, growth factors, etc.) in treating cartilage defects in the human hip. The method includes the steps of determining the voltage and current output that produces the desired 20 mV/cm electric field in the articular cartilage of the human hip joint, and other voltage and current values for other effective electric field amplitudes thought or known to be effective. The method includes constructing an anatomic model of the human hip joint and translating the anatomic model to an analytical model of the hip in which the dimensions for the tissues encountered from skin (anterior) through fat and skin (posterior) are determined. Planar circuits were then constructed in which the various tissue conductivities, impedances and current flow were used in calculating the voltage and current required to be applied to surface electrodes placed anteriorly and posteriorly on the skin covering the hip in order to produce an electric field at 20 mV/cm in articular cartilage of the hip joint at a frequency of 60 kHz. One knowledgeable in the field could perform the same analysis at other frequencies, adjust the tissue impedances to their values at the new frequency and obtain different values for the ranges of the electrical field and current density at any chosen frequency or set of frequencies.
  • The invention also includes a method and a device for treating diseased tissue (such as osteoarthritis), defective or injured tissue in a human hip joint through the application of a specific and selective electric or electromagnetic field to the afflicted tissue in the human hip joint. Such a device in accordance with a capacitive coupling embodiment of the invention includes at least two electrodes adapted for application in the proximity of a patient's hip joint and a signal generator that generates electric signals for application to the electrodes so as to produce an electric field of amplitude of 20 mV/cm±15% and a current density of 120 μA/cm2±15% within the synovium and articular cartilage of the patient's hip joint. An inductive coupling embodiment of the invention includes a coil(s) or solenoid adapted and configured to receive the electric signals to produce these electric fields. Preferably, the signal generator provides one of a plurality of output electric signals with a voltage selected by a user in accordance with a size of the human hip joint. Larger hip joints receive signals of larger voltages.
  • These and other aspects of the present invention will be elucidated in the following detailed description of the invention.
  • BRIEF DESCRIPTION OF THE DRAWINGS
  • The present invention will be apparent from the following detailed description of the invention in conjunction with the accompanying drawings, of which:
  • FIG. 1 illustrates an anatomic model of the human hip joint showing all the important tissues and structures through which the current passes between the anterior and posterior surface electrodes placed on skin.
  • FIG. 2 illustrates an analytical model of the human hip joint from which size parameters are determined for each of the tissues and structures indicated.
  • FIG. 3A illustrates a planar circuit model of the human hip joint showing circumferential flow of current through the fat layers (I3) plus leakage flow of current through the muscle and other soft tissue (I4), plus current flow across the hip joint (I2) and the impedance (Z) compartments.
  • FIG. 3B illustrates a planar circuit showing in detail the current flow and impedances across the hip joint (ZT1).
  • FIG. 4 illustrates schematically the three currents that were calculated in determining the output current and voltage required to produce a 20 mV/cm field in the articular cartilage of the hip joint. The three currents are the circumferential current, the leakage current, and the current flowing through the hip joint.
  • FIG. 5 illustrates electrode placement on the skin that is required to produce the desired electric field in the hip joint.
  • DETAILED DESCRIPTION OF ILLUSTRATIVE EMBODIMENTS
  • The invention will be described with reference to FIGS. 1-5 and Tables 1-3. Those skilled in the art will appreciate that the description given herein with respect to these figures is for exemplary purposes only and is not intended in any way to limit the scope of the invention. All questions regarding the scope of the invention may be resolved by referring to the appended claims.
  • Definitions:
  • As used herein, the term “signal” is used to refer to a variety of signals including mechanical signals, ultrasound signals, electromagnetic signals, and electric signals outputted by a device.
  • As used herein, the term “field” refers to an electric field within a targeted tissue, whether it is a combined field or a pulsed electromagnetic field, or generated by direct current, capacitive coupling, or inductive coupling.
  • Determination of Voltage and Current:
  • Previous studies by the present inventors have shown that a capacitively coupled field significantly increased the proliferation of bone cells grown in culture (Brighton, Pollack, et al, V. Orthop. Research, 3:331-340, 1985) and significantly increased the rate of healing in a rat fractured fibula model (Brighton, Pollack, et al, Clin. Orthop. And Related Research, 285:255-262, 1992). Also, the field distributions in the vertebral bodies of rats during capacitively coupled electrical stimulation have been determined (Carter, Vresilovic, Pollack, and Brighton, IEEE transactions on Biomedical Engineering, 36(-3): 333-3345, 1989). In order to determine the required output voltage and current required to produce an equivalent electric field and current density in a human hip joint, the analytical model depicted in FIG. 2 was developed in accordance with the invention for representing the typical human hip joint illustrated in FIG. 1.
  • As shown in FIG. 1, the typical human hip joint includes layers of cartilage and synovial fluid that is bounded by the acetabulum and the femoral head. In accordance with the invention, osteoarthritis, cartilage disease, defects and injuries in the hip joint is treated by the application of specific and selective electric fields via electrodes 10, 20 attached relative to the hip joint substantially as shown in FIG. 1. A signal generator 30 provides the appropriate signals to the electrodes for generating the specific and selective electric fields. The specific and selective electric field needed to treat osteoarthritis, cartilage disease, defects and injuries in the hip joint is calculated in accordance with the invention using the analytical model of the hip joint depicted in FIG. 2.
  • FIG. 1 illustrates an anatomical model for use in determining the electric field amplitude and current density obtained in the cartilage space in a hip joint when electrodes 10, 20 are placed anteriorly and posteriorly, respectively, and a voltage is applied causing a current to flow through the body. In the analytical model of FIG. 2, the following elements are identified as indicated: electrodes 10, 20, skin 40, fat 50, muscle 60, bone (acetabulum) 70, cartilage and synovial fluid 80, and femoral head 90. In an exemplary embodiment, the frequency of a sine wave voltage is taken to be 60 kHz; however, the methodology described herein can be applied to any frequency as long as the electrical properties of the tissues are chosen for those frequencies. It is desired to determine the voltage and the current to be applied to the electrodes 10, 20 in order to obtain in the cartilage of the hip joint a therapeutic electric field amplitude of 20 mV/cm in a preferred embodiment, and voltage and current values for other effective electric field amplitudes known to be effective.
  • It is clear from FIGS. 1 and 2 that patients of different sizes may require different applied voltages and currents to achieve the therapeutic electric field amplitudes. Accordingly, the calculation in accordance with the invention will model the patient for four (4) different size classifications. The essential geometric model parameters for these four sizes along with the relevant electrical properties of all tissue types are shown below in Tables 1A and 1B with reference to the distances illustrated in FIG. 2. The electrodes 10, 20 are assumed to be 2″×2″ square and the currents are calculated by considering the current flow through the patient's body for a 2″×2″ rectangle from one electrode to the other plus the circumferential flow of current through the fat layer plus the leakage current that flows through the muscle and other soft tissues outside of the 2″×2″ rectangle but excluding the circumferential current in the fat layer. These currents are shown in FIGS. 3 and 4. The impedances of the tissue compartments through which the current I2 (FIG. 3) flows are shown in FIG. 3B. A line drawing showing patient electrode placement is presented in FIG. 5. In FIG. 5, the region in broken lines is modeled as a 2″×2″ rectangle 100 in which the body current is assumed to flow. Leakage currents as shown in FIGS. 3A and 4 include circumferential flow in the fat layer and body currents outside of the 2″×2″ rectangle 100. The current flow and impedance through region 100 are those shown in FIG. 3B.
  • TABLE 1A
    Size Parameters for Four Patient Classifications
    Patient Classification
    Small Medium Large Extra-Large
    Measurement (m) (m) (m) (m)
    Electrode-to electrode 0.1524 0.18 0.21 0.305
    distance (D*)
    Fat layer thickness (F*) 0.00635 0.00762 0.0222 0.699
    Fat layer width 0.051 0.051 0.051 0.051
    Muscle (M3*) length 0.051 0.0635 0.0635 0.0635
    Muscle (M3*) width 0.051 0.051 0.051 0.051
    Muscle (M4*) length 0.0635 0.0762 0.0762 0.0762
    Muscle (M4*) width 0.0254 0.0254 0.0254 0.0254
    Muscle (M8*) length 0.0254 0.0254 0.0254 0.0254
    Muscle (M8*) width 0.051 0.051 0.051 0.051
    Cartilage junction length 0.08 0.08 0.08 0.08
    Cartilage junction width 0.0127 0.0127 0.0127 0.0127
    Femoral head radius (R*) 0.0254 0.0254 0.0254 0.0254
    Acetabular thickness (B*) 0.015 0.015 0.015 0.015
    Acetabular width 0.04 0.04 0.04 0.04
    *See FIG. 2
  • TABLE 1B
    Electrical Conductivities
    TISSUE CONDUCTIVITY
    Fat 0.02 S/m
    Muscle 0.45 S/m
    Bone 0.01 S/m
    Cartilage 0.6 S/m
    Skin Admittance 3 × 10−3 S/cm2
  • The definitions of terms in FIGS. 2, 3A, 3B and 4 are shown below in Table 2. Each impedance labeled in FIGS. 3 and 4 was calculated using the relationship:
  • Z = 1 σ · Length Area ( Equation 1 )
  • Where Length is the dimension of the tissue in the direction of the current flow, Area is the cross-sectional area of the tissue perpendicular to the direction of current flow, and a is the electrical conductivity.
  • TABLE 2
    Definitions of dimensions and symbols shown in FIGS. 2 and 3
    D = electrode to electrode distance
    F = fat layer thickness
    M = muscle: M3 = distance (thickness) of muscle from posterior fat layer
    to posterior acetabulum
    M4 = distance (thickness) of muscle from posterior
    acetabulum to anterior acetabulum
    M8 = distance (thickness) of muscle from anterior
    acetabulum to anterior fat layer
    Z = impedance: Z1 = impedance of skin
    Z2 = impedance of fat
    Z3 = impedance of muscle posterior
    to the acetabulum
    Z4 = impedance of the muscle around the
    hip joint
    Z5 = impedance of bone (acetabulum)
    ZFH {open oversize brace} Z6 = impedance of bone (femoral head)
    Z7 = impedance of articular cartilage-
    synovium
    Z8 = impedance of muscle anterior to the
    acetabulum
    ZT1 = impedance across the hip joint;
    i.e., the combined impedance from Point A
    to Point B in FIG. 3B
    I = current: Itotal = total current flowing from electrode to electrode
    IFH = current flowing through hip joint
    I4 = current flowing through muscle
    I6 = current flowing through femoral head
    I7 = current flowing through articular cartilage
    B = Bone (acetabulum) thickness
    C = cartilage-synovium thickness
    R = radius of femoral head
    J = current density (A/cm2)
    E = electric field (V/cm)
  • The impedances were then calculated using Equation 1, the dimensions in Table 1A and the conductivities in Table 1B. Using standard lump circuit analysis for series/parallel impedances, the total current, I1 (FIG. 3A) that must flow from the electrodes was calculated for each patient classification for a voltage applied to the electrodes. In addition, I2, the current flow through the muscle-femur-cartilage-muscle layers; the current I3, the current flowing circumferentially through the fat layer and I4, the leakage currents, were also calculated. This enabled the calculation of the current through the cartilage, Icartilage, and the current density, Jcartilage, from which the electric field amplitude in the cartilage, Ecartilage, could be computed from the equation:

  • J cartilagecartilage ·E cartilage  (Equation 2)
  • where Jcartilage and Ecartilage are described above and σcartilage is the electrical conductivity of the cartilage as shown in Table 1B. These results are summarized in Table 3A. From Table 3A, it is apparent that for an applied voltage of approximately 5 V peak-to-peak sine wave at 60 kHz, one obtains electric fields of 20 mV/cm±3.5 mV/cm for the small, medium and large patient, but not for the extra-large patient. The extra-large patient requires a voltage that is approximately twice that required for the other three patient sizes.
  • TABLE 3A
    Device Voltage and Current Required to Apply 20 mV/cm
    Electric Field to Cartilage in the Human Hip
    Device Current Electrode Current
    Patient Size Device Voltage (2″ × 2″ electrode) Density
    Small 4.3 Vp-p 26.8 mA 1.04 mA/cm2
    Medium 4.5 Vp-p 31.6 mA 1.23 mA/cm2
    Large 5.7 Vp-p 32.0 mA 1.24 mA/cm2
    Extra Large 10.2 Vp-p  52.1 mA 2.02 mA/cm2
  • It is now possible to calculate the device current to the 2″×2″ electrodes 10, 20 in order to achieve a 20 mV/cm electric field amplitude in the cartilage. These values, and the approximate device voltages that achieve these device currents are shown below in Table 3B along with the current and current density in the cartilage when the applied voltage is as shown for each patient size:
  • TABLE 3B
    Cartilage Current and Current Density When a 20 mV/cm
    Electric Field is Applied to the Cartilage of the Human Hip
    Patient Size Cartilage Current Cartilage Current Density
    Small 0.15 mA 120 μA/cm2
    Medium 0.15 mA 120 μA/cm2
    Large 0.15 mA 120 μA/cm2
    Extra Large 0.15 mA 127 μA/cm2
  • It is noted that for extra-large patients, the current density value at the electrodes, 2.02 mA/cm2, is at the maximum value and should not be exceeded.
  • It is understood that patients with a specific size, i.e., electrode-to-electrode dimension, may have tissue compartment sizes and/or skin impedance values that differ from those modeled here. Therefore, devices that power the electrodes should have output variability to increase the peak-to-peak voltage to achieve the desired electrode current (density).
  • The current (or electric field) that flows through the cartilage of the hip when a voltage is applied to the electrodes on the skin is determined by the impedances shown in FIGS. 3A and 3B. For a given patient size, the dimensions of various tissue compartments (and therefore their impedances) can vary so that the current that actually flows through the cartilage could be higher or lower than the values shown for an applied device voltage as shown above. Taking reasonable variations in dimensions of the tissue compartments for each patient size, it may be determined that for a given device voltage, the cartilage current (and therefore the cartilage electric field) could differ by ±15%. Therefore, in order to account for this variation, and to account for the variation of skin electrical impedance from patient to patient, the device should be designed to apply the device current value plus or minus 15% to the pair of 2″×2″ electrodes 10, 20.
  • Thus, in accordance with the invention, the approximate size of the patient's hip is determined, and a signal is generated and applied to the electrodes that will generate the desired electric field with a voltage of 20 mV/cm±15% and a current density of 120 μA/cm2±15% within the synovium and articular cartilage for treatment of osteoarthritis in the hip, for example. Preferably, the signal generator includes a select control (FIG. 1) that allows the operator to select the proper output based on the size of the patient's hip.
  • Although implementations of the invention have been described in detail above, those skilled in the art will readily appreciate that many additional modifications are possible without materially departing from the novel teachings and advantages of the invention. For example, those skilled in the art will appreciate that the techniques of the invention may be applied to capacitive and inductive coupling systems. In the case of capacitive coupling, the scaled voltage and current are applied to the hip region using two electrodes as illustrated in FIGS. 1 and 2. On the other hand, in the case of inductive coupling, the scaled voltage and current are applied to the hip region using a solenoid or coil(s). Any such modifications are intended to be included within the scope of the invention as defined in the following claims.

Claims (23)

1. A method of treating disease tissue in a human through the application of a specific and selective electric or electromagnetic field to the disease tissue in the human, comprising the steps of:
a. Determining the voltage and current output that produces a 20 mV/cm electric field in the diseased tissue of the human;
b. Constructing an anatomic model of human diseased tissue showing all the pertinent tissues and structures through which the current passes between the skin overlying one side of the diseased tissue through the skin on the opposite side of the diseased tissue;
c. Constructing an analytic model of the diseased tissue from which size parameters are determined for each of the tissues and structures through which the current passes between the anterior and posterior skin surfaces enclosing the diseased tissue;
d. Constructing a planar circuit model of the diseased tissue giving the impedance and current flow in detail of all the structures and tissues through which the current must flow to achieve a 20 mV/cm electric field in the diseased tissue;
e. Computing the electric field amplitude (20 mV/cm) in the diseased tissue as equal to the targeted diseased tissue current density divided by the targeted diseased tissue conductivity; and
f. Applying the computed voltage and current to the diseased tissue of the human.
2. The method of claim 1 wherein the computed voltage and current applying step comprises the step of applying the computed voltage and current to the human using two electrodes in the case of capacitive coupling.
3. The method of claim 1 wherein the computed voltage and current applying step comprises the step of applying the computed voltage and current to the human using a solenoid or coil(s) in the case of inductive coupling.
4. The method of claim 1 wherein the voltage and current output determining step comprises the step of determining the voltage and current output that produces a 20 mV/cm electric field in the tissues of the diseased human hip.
5. The method of claim 4 wherein the anatomic model constructing step comprises the step of constructing an anatomic model of the human hip.
6. The method of claim 5 wherein the step of constructing an anatomic model of the diseased tissue comprises the step of constructing an analytic model of the diseased human hip from which size parameters are determined for each of the tissues and structures through which the current passes between anterior and posterior skin surfaces enclosing the human hip.
7. The method of claim 6 wherein the step of constructing the planar circuit model comprises the step of constructing a planar circuit model of the human hip in order to determine the circumferential flow of current through a fat layer, a leakage flow of current through muscle and other soft tissue, and current flow across and through the human hip.
8. The method of claim 7 wherein the step of constructing the planar circuit model comprises the step of constructing a planar circuit model of the human hip giving the impedance and current flow of all the tissues and structures through which the current must flow to achieve a 20 mV/cm electric field in the human hip.
9. The method of claim 8 wherein the step of computing the electric field amplitude comprises the set of computing the desired electric field amplitude (20 mV/cm) in the diseased human hip as equal to the current density in the tissues of the hip divided by the conductivity of the tissues in the hip.
10. The method of claim 1 wherein the computed voltage and current are applied to a diseased human hip.
11. A device for treating diseased tissue in the human hip joint through the application of a specific and selective electric or electromagnetic field to the diseased or injured tissue in the human hip joint comprising:
a. one of (a) at least two electrodes, in the case of capacitive coupling, adapted for application in the proximity of a patient's hip joint; and (b) a solenoid or at least one coil, in the case of inductive coupling, adapted for application in the proximity of a patient's hip joint; and
b. a signal generator that generates electric signals for application to the electrodes, the solenoid, or at least one coil so as to produce an electric field of approximately 20 mV/cm±15% and a current density range of approximately 120 μA/cm2±15% within the synovium and articular cartilage of the patient's hip joint.
12. A device for treating osteoarthritis, cartilage defects due to trauma or sports injury, or used as an adjunct with other therapies for treating cartilage defects in a human hip joint through the application of specific and selective electric or electromagnetic field to the afflicted tissue in the human hip joint, comprising:
a. one of (a) at least two electrodes on the surface of the skin and (b) a solenoid or at least one coil located external to the skin adapted for application in the proximity of a patient's hip joint; and
b. a signal generator that generates electric signals for application to the electrodes, the solenoid, or at least one coil so as to produce an electric field of approximately 20 mV/cm±15% and a current density range of approximately 120 μA/cm2±15% within the synovium and articular cartilage of the patient's hip joint.
13. A device as in claim 12, wherein the signal generator provides one of the plurality of output electric signals in accordance with a size of the human hip joint and its surrounding soft tissue and skin.
14. A device as in claim 13, wherein one of the plurality of output electrical signals of the signal generator for a 60 kHz frequency has a voltage of approximately 4.3 Vp-p±10% for a small size hip joint.
15. A device as in claim 13, wherein one of the plurality of output electrical signals of the signal generator for a 60 kHz frequency has a voltage of approximately 4.5 Vp-p±10% for a medium sized hip joint.
16. A device as in claim 13, wherein one of the plurality of output electrical signals of the signal generator for a 60 kHz frequency has a voltage of approximately 5.7 Vp-p±10% for a large sized hip joint.
17. A device as in claim 13, wherein one of the plurality of output electrical signals of the signal generator for a 60 kHz frequency has a voltage of approximately 10.2 Vp-p±10% for a extra large sized hip joint.
18. A method of treating osteoarthritis in a human knee joint through the application of a specific and selective electric or electromagnetic field to the diseased tissue in the human knee joint, comprising the steps of:
converting electric potential into an electric signal that when applied to one of (a) at least two electrodes on the surface of the skin and (b) a solenoid or at least one coil located external to the skin adapted for application in the proximity of a patient's hip joint, an electric field of not less than approximately 20 mV/cm±15% is produced and a current density of not less than approximately 120 μA/cm2±15% is produced within the synovium and articular cartilage of the patient's hip joint; and
applying the electric signal to the at least two electrodes, solenoid or coil so as to produce the electric field within the synovium and articular cartilage of the patient's hip joint.
19. A method as in claim 18, comprising the additional step of selecting one of a plurality of output electric signals with a voltage in accordance with a size of the human hip joint.
20. A method as in claim 19, wherein the selecting step comprises the step of selecting an electrical signal having a voltage of approximately 4.3 Vp-p±10% for a small size hip joint.
21. A method as in claim 19, wherein the selecting step comprises the step of selecting an electrical signal having a voltage of approximately 4.5 Vp-p±10% for a medium sized hip joint.
22. A method as in claim 19, wherein the selecting step comprises the step of selecting an electrical signal having a voltage of approximately 5.7 Vp-p±10% for a large sized hip joint.
23. A method as in claim 19, wherein the selecting step comprises the step of selecting an electrical signal having a voltage of approximately 10.2 Vp-p±10% for a extra large sized hip joint.
US10/579,174 2003-11-14 2004-11-12 Method and device for treating osteoarthritis and cartilage disease, defects, and injuries in the human hip Abandoned US20090062885A1 (en)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
US52008803P 2003-11-14 2003-11-14
US53573404P 2004-01-09 2004-01-09
PCT/US2004/037926 WO2005049132A1 (en) 2003-11-14 2004-11-12 Method and device for treating osteoarthritis and cartilage disease, defects, and injuries in the human hip

Publications (1)

Publication Number Publication Date
US20090062885A1 true US20090062885A1 (en) 2009-03-05

Family

ID=34623117

Family Applications (2)

Application Number Title Priority Date Filing Date
US10/579,174 Abandoned US20090062885A1 (en) 2003-11-14 2004-11-12 Method and device for treating osteoarthritis and cartilage disease, defects, and injuries in the human hip
US10/987,866 Active 2024-11-19 US7215995B2 (en) 2003-11-14 2004-11-12 Method and device for treating osteoarthritis and cartilage disease, defects, and injuries in the human hip

Family Applications After (1)

Application Number Title Priority Date Filing Date
US10/987,866 Active 2024-11-19 US7215995B2 (en) 2003-11-14 2004-11-12 Method and device for treating osteoarthritis and cartilage disease, defects, and injuries in the human hip

Country Status (11)

Country Link
US (2) US20090062885A1 (en)
EP (1) EP1689487A4 (en)
JP (1) JP2007511289A (en)
CN (1) CN1893999A (en)
AU (1) AU2004291111A1 (en)
CA (1) CA2545860A1 (en)
IL (1) IL175619A0 (en)
MX (1) MXPA06005358A (en)
NO (1) NO20062787L (en)
NZ (1) NZ547198A (en)
WO (1) WO2005049132A1 (en)

Cited By (13)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2012102837A1 (en) * 2011-01-25 2012-08-02 Willeford Kenneth L Method and device for treating osteoarthritis noninvasively
US8460167B2 (en) 2009-09-14 2013-06-11 Minnesota Medical Physics Llc Thermally assisted pulsed electro-magnetic field stimulation device and method for treatment of osteoarthritis
US8827886B2 (en) 2009-09-14 2014-09-09 Minnesota Medical Physics Llc Thermally assisted pulsed electro-magnetic field stimulation device and method for treatment of osteoarthritis
US8932196B2 (en) 2009-09-14 2015-01-13 Minnesota Medical Physics Llc Thermally assisted pulsed electro-magnetic field stimulation device and method for treatment of osteoarthritis
US8972019B2 (en) 2011-01-25 2015-03-03 Kenneth L. Willeford Method and device for treating osteoarthritis noninvasively
CN108310655A (en) * 2013-03-15 2018-07-24 纳特维斯公司 For implementing to treat, such as the controller and flexible coil for the treatment of of cancer
US10806942B2 (en) 2016-11-10 2020-10-20 Qoravita LLC System and method for applying a low frequency magnetic field to biological tissues
US11285317B2 (en) 2015-12-29 2022-03-29 Rainbow Medical Ltd. Disc therapy
US11298530B1 (en) 2021-05-03 2022-04-12 Discure Technologies Ltd. Synergistic therapies for intervertebral disc degeneration
US11344721B1 (en) * 2021-08-16 2022-05-31 Rainbow Medical Ltd. Cartilage treatment
US11413455B1 (en) 2022-02-08 2022-08-16 Rainbow Medical Ltd. Electrical treatment of Alzheimer's disease
US11484706B2 (en) 2015-12-29 2022-11-01 Discure Technologies Ltd Disc therapy
US11583201B2 (en) 2017-12-28 2023-02-21 Pontificia Universidad Catolica De Chile Device for recording the vascular response of the human spinal cord triggered by a suprasensible stimulus through the use of functional near-infrared spectroscopy

Families Citing this family (47)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US7981611B2 (en) * 2000-02-23 2011-07-19 The Trustees Of The University Of Pennsylvania Regulation of fibroblastic growth factor-2 (FGF-2) gene expression in living cells with the application of specific and selective electric and electromagnetic fields
WO2005070136A2 (en) * 2004-01-12 2005-08-04 The Trustees Of The University Of Pennsylvania Up-regulation of bone morphogenetic protein (bmp) gene expression in bone cells by electromagnetic signals
US7374916B2 (en) 2000-02-23 2008-05-20 The Trustees Of The University Of Pennsylvania Regulation of aggrecan gene expression using specific and selective electrical and electromagnetic signals
US7022506B2 (en) * 2000-02-23 2006-04-04 The Trustees Of The University Of Pennsylvania Method and device for treating osteoarthritis, cartilage disease, defects and injuries in the human knee
US7429471B2 (en) * 2000-02-23 2008-09-30 The Trustees Of The University Of Pennsylvania Regulation of matrix metalloproteinase gene expression using specific and selective electrical and electromagnetic signals
US7465566B2 (en) * 2000-02-23 2008-12-16 The Trustees Of The University Of Pennsylvania Regulation of genes via application of specific and selective electrical and electromagnetic signals
US7465546B2 (en) * 2000-02-23 2008-12-16 The Trustees Of The University Of Pennsylvania Regulation of transforming growth factor-beta (TGF-β) gene expression in living cells via the application of specific and selective electric and electromagnetic fields
US8313908B2 (en) 2000-02-23 2012-11-20 The Trustees Of The University Of Pennsylvania Regulation of stem cell gene production with specific and selective electric and electromagnetic fields
US9656096B2 (en) 2003-12-05 2017-05-23 Rio Grande Neurosciences, Inc. Method and apparatus for electromagnetic enhancement of biochemical signaling pathways for therapeutics and prophylaxis in plants, animals and humans
US9440089B2 (en) 2003-12-05 2016-09-13 Rio Grande Neurosciences, Inc. Apparatus and method for electromagnetic treatment of neurological injury or condition caused by a stroke
US10350428B2 (en) 2014-11-04 2019-07-16 Endonovo Therapetics, Inc. Method and apparatus for electromagnetic treatment of living systems
US8961385B2 (en) * 2003-12-05 2015-02-24 Ivivi Health Sciences, Llc Devices and method for treatment of degenerative joint diseases with electromagnetic fields
US20110112352A1 (en) * 2003-12-05 2011-05-12 Pilla Arthur A Apparatus and method for electromagnetic treatment
US7744524B2 (en) * 2003-12-05 2010-06-29 Ivivi Health Sciences, Llc Apparatus and method for electromagnetic treatment of plant, animal, and human tissue, organs, cells, and molecules
US9415233B2 (en) 2003-12-05 2016-08-16 Rio Grande Neurosciences, Inc. Apparatus and method for electromagnetic treatment of neurological pain
US9433797B2 (en) 2003-12-05 2016-09-06 Rio Grande Neurosciences, Inc. Apparatus and method for electromagnetic treatment of neurodegenerative conditions
US20130218235A9 (en) * 2005-03-07 2013-08-22 Arthur A. Pilla Excessive fibrous capsule formation and capsular contracture apparatus and method for using same
US8454543B2 (en) * 2004-03-10 2013-06-04 Vision Quest Industries Incorporated Electrodes for orthotic device
US8070703B2 (en) * 2004-03-10 2011-12-06 Vision Quest Industries Incorporated Electrically stimulating orthotic device and segmented liner
US8936560B2 (en) 2004-03-10 2015-01-20 Vision Quest Industries Incorporated Bracing and electrostimulation for arthritis
KR20070024533A (en) 2004-04-19 2007-03-02 아이비비 테크놀로지스, 아이엔씨. Electromagnetic treatment apparatus and method
US8082038B2 (en) * 2004-07-09 2011-12-20 Ebi, Llc Method for treating degenerative disc disease using noninvasive capacitively coupled electrical stimulation device
US7473678B2 (en) 2004-10-14 2009-01-06 Biomimetic Therapeutics, Inc. Platelet-derived growth factor compositions and methods of use thereof
WO2007061889A2 (en) * 2005-11-17 2007-05-31 Biomimetic Therapeutics, Inc. Maxillofacial bone augmentation using rhpdgf-bb and a biocompatible matrix
US8078282B2 (en) * 2006-02-01 2011-12-13 Warsaw Orthopedic, Inc Implantable tissue growth stimulator
EP2311505B1 (en) * 2006-02-09 2013-11-06 BioMimetic Therapeutics, LLC Compositions and methods for treating bone
AU2007269712B2 (en) 2006-06-30 2013-02-07 Biomimetic Therapeutics, Llc PDGF-biomatrix compositions and methods for treating rotator cuff injuries
US9161967B2 (en) 2006-06-30 2015-10-20 Biomimetic Therapeutics, Llc Compositions and methods for treating the vertebral column
US20090018613A1 (en) * 2006-08-02 2009-01-15 Genestim, Llc Regulation of vascular endothelial growth factor (vegf) gene expression in tissue via the application of electric and/or electromagnetic fields
EP2086598B1 (en) 2006-11-03 2015-05-27 BioMimetic Therapeutics, LLC Compositions and methods for arthrodetic procedures
US7783348B2 (en) * 2007-05-03 2010-08-24 Orthocor Medical, Inc. Stimulation device for treating osteoarthritis
US8768454B2 (en) * 2007-05-03 2014-07-01 Orthocor Medical, Inc. Electromagnetic thermal therapy
US9968797B2 (en) 2007-05-03 2018-05-15 Orthocor Medical, Inc. Electromagnetic thermal therapy
US8548586B2 (en) * 2008-01-29 2013-10-01 Cardiac Pacemakers, Inc. Configurable intermittent pacing therapy
JP5864106B2 (en) 2008-02-07 2016-02-17 バイオミメティック セラピューティクス, エルエルシー Compositions and methods for callus extension
JP5816553B2 (en) 2008-09-09 2015-11-18 バイオミメティック セラピューティクス, エルエルシー Platelet-derived growth factor compositions and methods for treating tendon or ligament injury
US20100099942A1 (en) * 2008-10-20 2010-04-22 Lucas Portelli Method and apparatus for electromagnetic human and animal immune stimulation and/or repair systems activation
US20100324626A1 (en) * 2009-06-23 2010-12-23 Management Technologies, Inc. Electrotherapy Stimilator for Osteoarthritis
MX2012009687A (en) 2010-02-22 2012-11-29 Biomimetic Therapeutics Inc Platelet-derived growth factor compositions and methods for the treatment of tendinopathies.
CA2813036A1 (en) 2010-10-01 2012-04-05 Ivivi Health Sciences, Llc Method and apparatus for electromagnetic treatment of head, cerebral and neural injury in animals and humans
EP2736588A4 (en) 2011-07-27 2015-06-10 Vision Quest Ind Inc Dba Vq Orthocare Electrostimulation system
US8343027B1 (en) 2012-01-30 2013-01-01 Ivivi Health Sciences, Llc Methods and devices for providing electromagnetic treatment in the presence of a metal-containing implant
US9044611B2 (en) * 2013-03-15 2015-06-02 The Regents Of The University Of California Systems and methods for selectively migrating cells using electric fields
EP3131628A4 (en) 2014-04-16 2017-11-22 Ivivi Health Sciences, LLC A two-part pulsed electromagnetic field applicator for application of therapeutic energy
CN110090358A (en) * 2018-01-29 2019-08-06 邦尼塔斯研究中心有限公司 Blood magnetic stimulating device
CN108031002B (en) * 2018-02-08 2021-06-29 中国医科大学附属盛京医院 Electrical stimulation apparatus for promoting regeneration of autograft fat flap
DE102018112297B4 (en) * 2018-05-23 2022-06-30 Universität Rostock Implant arrangement for electrical stimulation of cartilage tissue

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040138709A1 (en) * 2000-02-23 2004-07-15 Brighton Carl T. Regulation of matrix metalloproteinase gene expression using specific and selective electrical and electromagnetic signals

Family Cites Families (37)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2432493C2 (en) * 1974-07-04 1985-01-03 Werner Dipl.-Ing. 8000 München Kraus Solenoid coil for an electromagnetic therapy device
US4442846A (en) * 1981-11-10 1984-04-17 University Of Pennsylvania Distributed port bone-piercing cathode for electrically stimulated osteogenesis
US4506674A (en) * 1981-11-10 1985-03-26 Trustees Of The University Of Pennsylvania Method of stimulating osteogenesis with distributed port cathode
US4430999A (en) * 1981-11-10 1984-02-14 Trustees Of The University Of Pennsylvania Osteogenesis stimulating cathode assembly for use with an internal fixation device
US4459988A (en) * 1982-02-22 1984-07-17 Biolectron, Inc. Electrical stimulating apparatus
US4509520A (en) * 1982-02-22 1985-04-09 Biolectron, Inc. Electrical stimulating apparatus
US4549547A (en) * 1982-07-27 1985-10-29 Trustees Of The University Of Pennsylvania Implantable bone growth stimulator
US4487834A (en) * 1982-09-17 1984-12-11 Biolectron, Inc. Electrical stimulation of articular chondrocytes
US4467809A (en) * 1982-09-17 1984-08-28 Biolectron, Inc. Method for non-invasive electrical stimulation of epiphyseal plate growth
US4467808A (en) * 1982-09-17 1984-08-28 Biolectron, Inc. Method for preventing and treating osteoporosis in a living body by using electrical stimulation non-invasively
US5269746A (en) * 1982-12-20 1993-12-14 Jacobson Jerry I Therapeutic treatment of mammals for epilepsy and Parkinson's disease
US4535775A (en) * 1983-02-10 1985-08-20 Biolectron, Inc. Method for treatment of non-union bone fractures by non-invasive electrical stimulation
IT1159024B (en) * 1983-06-02 1987-02-25 Ruggero Cadossi METHOD AND DEVICE FOR THE TREATMENT OF FABRICS AND LIVING CELLS THROUGH ELECTROMAGNETIC FIELDS BUTTONS
US4600010A (en) * 1984-10-04 1986-07-15 Biolectron, Inc. Electric stimulator and test instrument therefor
US5014699A (en) * 1986-05-23 1991-05-14 Trustees Of The University Of Pennsylvania Electromagnetic method and apparatus for healing living tissue
US6120502A (en) * 1988-06-13 2000-09-19 Michelson; Gary Karlin Apparatus and method for the delivery of electrical current for interbody spinal arthrodesis
US5038797A (en) * 1990-02-20 1991-08-13 Romaine, Incorporated Electrical stimulation treatment device and method of use
US5273033A (en) * 1991-09-19 1993-12-28 Murray Electronics Associates Limited Partnership Electrical stimulation for treatment of osteoarthritis
US5338286A (en) * 1992-12-08 1994-08-16 Electro-Biology, Inc. Electromagnetic bioresponse by selective spectral suppression in pulsed field stimulation
US5374283A (en) * 1993-12-01 1994-12-20 Flick; A. Bart Electrical therapeutic apparatus
US6261221B1 (en) * 1996-11-01 2001-07-17 Amei Technologies Inc. Flexible coil pulsed electromagnetic field (PEMF) stimulation therapy system
US6132362A (en) * 1996-11-01 2000-10-17 Amei Technologies, Inc. Pulsed electromagnetic field (PEMF) stimulation therapy system with bi-phasic coil
US5743844A (en) * 1996-11-01 1998-04-28 Amei Technologies, Inc. High efficiency pulsed electromagnetic field (PEMF) stimulation therapy method and system
US5968527A (en) * 1997-02-27 1999-10-19 Catholic University Of America, The Protection of living systems from the adverse effects of stress
US6083149A (en) 1997-10-22 2000-07-04 Emf Therapeutics, Inc. Magnetic field device and method for inhibiting angiogenesis and retarding growth rates of tumors in mammals
US6186940B1 (en) * 1998-05-18 2001-02-13 Robert N. Kirschbaum Energized trace elements
AU5241699A (en) * 1998-08-03 2000-02-28 Amei Technologies Inc. Pemf treatment for osteoporosis and tissue growth stimulation
JP2003525591A (en) * 1999-04-29 2003-09-02 ノース・ショア・ロング・アイランド・ジューイッシュ・リサーチ・コーポレイション Methods for inducing neural tissue growth and enhancing survival
US6735468B2 (en) * 2000-02-02 2004-05-11 Massachusetts Institute Of Technology Arthroscopic impedance probe to detect cartilage degeneration
US7374916B2 (en) * 2000-02-23 2008-05-20 The Trustees Of The University Of Pennsylvania Regulation of aggrecan gene expression using specific and selective electrical and electromagnetic signals
US7465566B2 (en) * 2000-02-23 2008-12-16 The Trustees Of The University Of Pennsylvania Regulation of genes via application of specific and selective electrical and electromagnetic signals
US7022506B2 (en) * 2000-02-23 2006-04-04 The Trustees Of The University Of Pennsylvania Method and device for treating osteoarthritis, cartilage disease, defects and injuries in the human knee
WO2005070136A2 (en) 2004-01-12 2005-08-04 The Trustees Of The University Of Pennsylvania Up-regulation of bone morphogenetic protein (bmp) gene expression in bone cells by electromagnetic signals
US6485963B1 (en) * 2000-06-02 2002-11-26 The United States Of America As Represented By The Administrator Of The National Aeronautics And Space Administration Growth stimulation of biological cells and tissue by electromagnetic fields and uses thereof
AU2002227147A1 (en) * 2000-11-02 2002-05-15 Keith L March Method and system for modulation of oscillating signals to enhance biologic effects
US20030233124A1 (en) * 2000-12-18 2003-12-18 Hajuku Institute For Health Science Co., Ltd. Methods of treating disorders by altering ion flux across cell membranes with electric fields
KR100427405B1 (en) * 2001-03-07 2004-04-17 박재만 Pssc complex girder

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20040138709A1 (en) * 2000-02-23 2004-07-15 Brighton Carl T. Regulation of matrix metalloproteinase gene expression using specific and selective electrical and electromagnetic signals

Cited By (16)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8460167B2 (en) 2009-09-14 2013-06-11 Minnesota Medical Physics Llc Thermally assisted pulsed electro-magnetic field stimulation device and method for treatment of osteoarthritis
US8827886B2 (en) 2009-09-14 2014-09-09 Minnesota Medical Physics Llc Thermally assisted pulsed electro-magnetic field stimulation device and method for treatment of osteoarthritis
US8932196B2 (en) 2009-09-14 2015-01-13 Minnesota Medical Physics Llc Thermally assisted pulsed electro-magnetic field stimulation device and method for treatment of osteoarthritis
WO2012102837A1 (en) * 2011-01-25 2012-08-02 Willeford Kenneth L Method and device for treating osteoarthritis noninvasively
US8972019B2 (en) 2011-01-25 2015-03-03 Kenneth L. Willeford Method and device for treating osteoarthritis noninvasively
CN108310655A (en) * 2013-03-15 2018-07-24 纳特维斯公司 For implementing to treat, such as the controller and flexible coil for the treatment of of cancer
US11484706B2 (en) 2015-12-29 2022-11-01 Discure Technologies Ltd Disc therapy
US11285317B2 (en) 2015-12-29 2022-03-29 Rainbow Medical Ltd. Disc therapy
US11612742B2 (en) 2015-12-29 2023-03-28 Discure Technologies Ltd. Disc therapy
US11344741B2 (en) 2016-11-10 2022-05-31 Qoravita LLC System and method for applying a low frequency magnetic field to biological tissues
US10806942B2 (en) 2016-11-10 2020-10-20 Qoravita LLC System and method for applying a low frequency magnetic field to biological tissues
US11826579B2 (en) 2016-11-10 2023-11-28 Mannavibes Inc. System and method for applying a low frequency magnetic field to biological tissues
US11583201B2 (en) 2017-12-28 2023-02-21 Pontificia Universidad Catolica De Chile Device for recording the vascular response of the human spinal cord triggered by a suprasensible stimulus through the use of functional near-infrared spectroscopy
US11298530B1 (en) 2021-05-03 2022-04-12 Discure Technologies Ltd. Synergistic therapies for intervertebral disc degeneration
US11344721B1 (en) * 2021-08-16 2022-05-31 Rainbow Medical Ltd. Cartilage treatment
US11413455B1 (en) 2022-02-08 2022-08-16 Rainbow Medical Ltd. Electrical treatment of Alzheimer's disease

Also Published As

Publication number Publication date
MXPA06005358A (en) 2006-07-10
AU2004291111A1 (en) 2005-06-02
NZ547198A (en) 2008-05-30
IL175619A0 (en) 2006-09-05
WO2005049132A1 (en) 2005-06-02
EP1689487A1 (en) 2006-08-16
US7215995B2 (en) 2007-05-08
CA2545860A1 (en) 2005-06-02
US20050177203A1 (en) 2005-08-11
JP2007511289A (en) 2007-05-10
CN1893999A (en) 2007-01-10
EP1689487A4 (en) 2009-11-11
NO20062787L (en) 2006-08-14

Similar Documents

Publication Publication Date Title
US7215995B2 (en) Method and device for treating osteoarthritis and cartilage disease, defects, and injuries in the human hip
US7468264B2 (en) Method and device for treating osteoarthritis, cartilage disease, defects and injuries in the human knee
US6919205B2 (en) Regulation of type II collagen gene expression using specific and selective electrical and electromagnetic signals
USRE41391E1 (en) Regulation of type II collagen gene expression using specific and selective electrical and electromagnetic signals
US7374916B2 (en) Regulation of aggrecan gene expression using specific and selective electrical and electromagnetic signals
ZA200604880B (en) Method and device for treating osteoarthritis and cartilage disease, defects, and injuries in the human hip

Legal Events

Date Code Title Description
AS Assignment

Owner name: THE TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, PE

Free format text: ASSIGNMENT OF ASSIGNORS INTEREST;ASSIGNORS:BRIGHTON, CARL T;POLLACK, SOLOMON R;REEL/FRAME:021819/0924;SIGNING DATES FROM 20060801 TO 20081016

STCB Information on status: application discontinuation

Free format text: ABANDONED -- FAILURE TO RESPOND TO AN OFFICE ACTION