## 2 Application Fields
### Joint Preservation
[46] conducted a randomized multicenter trial on 68 patients after arthroscopic treatment for osteochondral defects (OCD) of the talus. During arthroscopic treatment, debridement and microfractures were performed to obtain a bone marrow stimulation. Following the surgery, a group of patients were also subjected to biophysical stimulation with PEMFs applied from the third post-operative day, for 60 days, with administration for 4 h a day. All patients performed physiotherapy rehabilitative activities with the same protocol. The aim of the study was to evaluate, compared to a placebo group, the timing of the resumption of sports and the number of patients returning to practice sports. To perform an objective clinical evaluation, the authors used the Ankle Activity Score (AAS) to evaluate, as a first outcome, the resumption of sport and the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score, Foot and Ankle Score (FAOS), EuroQol (EQ-5D), and Numeric Rating Scales (NRSS) for pain (at rest and when running), and satisfaction was a secondary outcome. The follow-up of the patients has been extended to carry out radiographic evaluations after 12 months, in order to compare the clinical results with the radiographic ones. The authors affirm that the application of PEMFs has not shown an improvement in the timing and the resumption of sport and the radiographical aspect, in this context, and that statistically significant differences have not been observed compared with the placebo group which also prolonged the evaluation to 12 months. Although the results showed no difference between the treated and control groups in the number of patients who returned to sport 1 year after surgery, in the PEMFs group 96% of patients returned to sport by week 30, while in the control group only 74% did (\(p=0.017\)). In the control group, the same percentage as the PEMFs group (96%) was achieved at week 52. In another clinical trial on patients with osteochondral lesions of the talus, treated using graft transplantation with the addition of bone marrow concentrate (BMDC) in a single operating session (ONE-STEP Method), [PERSON] et al. showed there was less pain in the experimental group with PEMFs at 2, 6, and 12 months of follow-up, and there were significantly higher functional results in the group of stimulated patients compared to the controls. Early rehabilitation with less pain can certainly lead to a better clinical outcome even after a long time [47]. Similar results were also found in a group of patients undergoing autologous chondrocytes transplantation in the presence of scaffolds (MACI) and who were treated with PEMFs. At the baseline, the two groups were perfectly comparable for clinical scores and cartilage injury characteristics. The International Knee Documentation Committee (IKDC) score showed a significant improvement in the treated group compared to the control at 1- (\(p=0.01\)), 2- (\(p=0.041\)), and 60 (\(p=0.001\))-month follow-ups. In addition, there was a statistically significant difference between the groups at 1 month (\(p=0.023\)) and 60 months for SF-36 (\(p=0.006\)) and at 60 months for EuroQol (\(p=0.020\)). A significant reduction in pain was observed in the treatment group compared to the control at 1 (\(p=0.018\)), 2 (\(p=0.043\)), and 60 (\(p=0.011\)) months of follow-up [48]. Clinical results from all studies show that the cartilage regeneration and/or repair method associated with PEMFs is an effective solution for the treatment of chondral and osteochondral lesions of the joint in the field of regenerative medicine and tissue engineering. Similar results are reported by [PERSON] et al. [2] in the narrative review conducted in 2019. This publication examined the results in various specialist fields, concluding positively regarding the application of biophysical therapies. The study examines the different fields of use to draw indications from the literature.