Optimizing Electrical Stimulation Parameters for Safe and Effective Cartilage Regeneration: A Computational Study on Thermal Dissipation in Articular Tissues

Studies have demonstrated that electrical stimulation (ES) can greatly enhance healing of chronic wounds and delay the effects of osteoarthritis (OA). Specifically, ES has been shown to promote tissue regeneration by increasing cellular proliferation and reducing inflammation by increasing electrokinetic perfusion within these tissues. However, questions persist about how to optimize this treatment and its potential limitations. For instance, understanding the relationship between voltage application and temperature thresholds that lead to cell death will assist clinicians in improving the process and avoiding tissue damage. This study presents a quantitative simulation-based analysis of the essential parameters for treating articular cartilage and the ohmic heating effects created by ES. Representative Computational Fluid Dynamics (CFD) simulations were used to quantify the effects of different voltage applications while monitoring temperature and time, aiming to determine when tissue undergoes irreversible damage due to thermal exposure. This study employed multiple model fidelities to examine the effects of blood flow in surrounding tissues and synovial fluid in the joint capsule, along with the thermal conductivity effects within articular cartilage, bone, and synovial fluid. Acquiring these results will aid in establishing thermal damage thresholds, enabling clinicians to begin to optimize treatment by understanding how the duration and intensity of an applied electric field correlates with patient safety and treatment efficacy.