Influence of Laser Irradiation Low Intensity on Reparative Osteogenesis and Angiogenesis Under Transosseous Osteosynthesis

Abstract

IntroductionThe use of non-medicinal facilities of correcting the processes of reparative regeneration for various pathological conditions is one of the most urgent problems in modern medicine. Laser therapy of different types is widely used in clinical practice including traumatology and orthopaedics for treating the locomotorium injuries and diseases, and it is aimed to provide the anesthetizing, anti-edematous, anti-inflammatory and trophic-stimulating effects. [1][2][3][4] Besides, it ensures the decrease in medicinal burden for the patient. The treatment with laser beams is comfortable, non-invasive, aseptic, painless, harmless, and controllable. 5,6 The low-energy laser has a multifactorial effect on the organism. 7,8 The enzymatic activity, as well as the rate of oxygen consumption by tissues increases, also the level of peroxide lipid oxidation decreases, oxidation-restoration processes activates, and the concentration of adaptive hormones increases.9,10 At the same time, the mechanism of laser therapeutic effects is largely unclear, and the doses are selected empirically. Both experimental-and-morphological studies in this field and information on infrared laser effect on reparative osteogenesis morphology are not numerous, 1,2,11 thereby evidencing the problem relevance, as well as the necessity of performing the present study. The purpose of the work is to study the efficiency of low-intensive of infrared laser irradiation in promoting reparative osteogenesis and angiogenesis during fracture treatment under transosseous osteosynthesis with a qualitative and quantitative morphological analysis. MethodsWe performed the experiments using 32 Wistar pubertal male rats of 340-390-g body weight in the control and experimental groups (16 animals each). We modeled a tibial fracture in the shaft middle third in a closed way under general anesthesia, performed reposition and fixation of fragments using the device worked out by us (Iryanov YM, Naumov EA, Iryanova TY; Russian Ilizarov Scientific Center Restorative Traumatology and Orthopaedics; Device for osteosynthesis of small bones. Russia patent 113651. 2012 February 12). One day after surgery the animals of the experimental group underwent low-energy pulsed infrared laser irradiation using a therapeutic laser device (laser therapy apparatus "Uzor A-2K, " country of origin: Russia), wavelength within the near-infrared range (0.89±0.02 µm), pulse frequency -150 Hz, power -4 W, pulse duration -110-160 The use of non-medicinal facilities of correcting processes for various pathological conditions is one of the most urgent problems of modern medicine. The purpose of the work is to study the efficiency of low-intensive of infrared laser irradiation in promoting reparative osteogenesis and angiogenesis during fracture treatment under transosseous osteosynthesis with a qualitative and quantitative morphological analysis. Methods: A tibial fracture was modeled experimentally in rats from control and experimental groups, then repositioning and fixation of fragments per...

Low level laser therapy promotes bone regeneration by coupling angiogenesis and osteogenesis

“…In recent years, many studies have shown that LLLT promotes the differentiation of bone marrow mesenchymal stem cells and promotes endothelial cells angiogenesis in vitro [ 16 , 35 , 36 ]. Meanwhile in vivo studies have confirmed that LLLT promotes angiogenesis, osteogenic differentiation of stem cells, and fracture healing [ 37 , 38 ]. However, whether LLLT is coupled with blood vessel formation, and bone formation is related to bone repair and regeneration, is not very clear.…”

Modern Physical Methods of Stimulating the Bone Tissue Healing Processes

“…Низькоінтенсивна лазеротерапіязастосування в медичних цілях лазерного випромінювання низької інтенсивності для якого характерні фіксована довжина хвилі (монохроматичність), однакова фаза випромінювання фотонів (когерентність), висока направленість та фіксована орієнтація векторів електромагнітного поля в просторі (поляризація). У фізіотерапії використовують переважно червоне та інфрачервоне випромінювання [29,30].…”

“…В основі репаративного ефекту НЛТ лежить активація проліферації низки клітин в зоні тканинного дефектумакрофагів, лімфоцитів, кератиноцитів, фібробластів, ендотеліальних клітинвнаслідок посилення продукції факторів росту судинного ендотелію (VEGF), фібробластів (FGF), тромбоцитарного фактору росту (PDGF) [29,31,32].…”

A atuação da laserterapia na angiogênese e no reparo tecidual

“…Atualmente, existem métodos para aliviar o processo inflamatório, proporcionando melhoria na nutrição celular e favorecendo o reparo tecidual danificado (Melo et al, 2011). O uso de terapias alternativas não medicinais para corrigir os processos de regeneração reparadora em várias condições patológicas é um dos problemas mais urgentes da Medicina Moderna (Iryanov, 2016).…”

“…A terapia com laser de diferentes tipos é amplamente utilizada na prática clínica e visa proporcionar os efeitos anestésicos, anti-edematosos, antiinflamatórios e tróficos-estimulantes. Além do mais, é um tratamento confortável, não-invasivo, asséptico, indolor, inofensivo e controlável (Iryanov, 2016), sendo bem tolerada por tecidos biológicos e sem associação com efeitos Deletérios (Fiório et al, 2011).…”