Gathering Evidence to Leverage Musculoskeletal Magnetic Stimulation Towards Clinical Applicability

Musculoskeletal disorders are among the main causes of disease-associated disability. Moreover, the incidence and prevalence of osteoporosis and osteoarthritis, as well as the risk of bone fractures and the need for joint replacements, are expected to increase with longer life expectancy. New approaches based on electromagnetic stimulation have been developed, aiming to shorten bone healing time, attenuate osteoporosis and osteoarthritis, and increase implants' osseointegration. Inductive coupling (IC), a non-invasive methodology to deliver magnetic stimuli, has reached clinical trials and some clinical practices but is not yet considered a standard procedure. Indeed, its feasibility in clinical use is still under discussion, and optimal stimulation parameters are fairly undefined. This comprehensive review describes the research trends and applicability of IC-based therapeutics for musculoskeletal disorders, and starts identifying top-performing magnetic stimulation parameters. Insights into the magnetic stimuli setups that promote osteogenesis are provided, based on pre-clinical and clinical evidence from 117 in vivo studies in animal models and human patients. Potential cellular and molecular biomechanisms mediating IC-induced effects on osteoblasts and osteoclasts are also explored. The transversal knowledge herein delivered will hopefully support innovative designs and medical devices that will implement IC stimulation as a clinical standard and effective therapeutic for musculoskeletal disorders.