Efeito da irradiação com laser de baixa intensidade na qualidade de membrana induzida pela técnica de Masquelet em coelhos
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Data
2020-12-02
Autores
Coris, Jeniffer Gabriela Figueroa [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
O estudo avaliou a influência da irradiação laser de baixa intensidade no desenvolvimento e características da membrana de Masquelet, induzida de forma ortotópica em coelhos. Foram utilizados 12 coelhos Norfolk com idade média de três meses. Em ambos os membros torácicos, foi induzida uma falha óssea segmentar de 1,0 cm de comprimento no rádio, a qual foi preenchida com um cilindro de cimento ortopédico. No período pós-operatório, em um dos membros a falha recebeu terapia laser de baixa intensidade (2J de energia) a cada 48 horas, durante 15 dias. As regiões das falhas segmentares foram avaliadas por exames ultrassonográficos e radiográficos. Seis animais foram submetidos à eutanásia com três semanas e seis com seis semanas de pósoperatório, para se proceder os exames histológicos e imuno-histoquímico das membranas de Masquelet. Em ambos os membros, radiograficamente notou-se na terceira semana de pós-operatório a presença de proliferação óssea ativa partindo das extremidades ósseas, sendo que na sexta semana o processo evolutivo mostrou-se em estágio mais avançado. O exame ultrassonográfico visibilizou, em ambos os membros, a presença da membrana induzida com uma semana de pós-operatório. Histologicamente não ocorreram diferenças estatísticas relativas ao escore semiquantitativo da intensidade de inflamação, número total de vasos sanguíneos, metaplasia óssea e colágeno. As espessuras médias das membranas induzidas foram 2050,17 µm e 1451,96 µm no membro controle e 2724,26 µm e 2081,03 µm no membro irradiado com laser, respectivamente na terceira e sexta semanas de pós-operatório. A expressão de VEGF e de PDGF foi presente nas membranas do membro controle e naquelas irradiadas, sem diferenças estatísticas. Foi possível concluir que pelos métodos de avaliação utilizados não foi possível comprovar estatisticamente a influência da irradiação laser de baixa intensidade sobre a membrana de Masquelet.
This study aimed to evaluate the influence of low-intensity laser irradiation on the development and characteristics of the Masquelet membrane induced in orthotopic site in rabbits. Twelve Norfolk rabbits, mean age of 3 months were used. In both forelimbs, a segmental bone defect of 1.0 cm length was induced in the radius, which was filled with a cylinder of polymethylmethacrylate bone cement. Low-level laser therapy was used postoperatively in the bone defect of one of the forelimbs by point technique (2J energy) every 48 hours for 15 days. The bone defect were evaluated by ultrasound and radiographic examinations. Six rabbits were submitted to euthanasia at three weeks postoperatively and six rabbits at six weeks postoperatively to perform the histological and immunohistochemical examinations of the Masquelet’s membranes. In both forelimbs, radiographs showed new bone growth from the cut ends of the radius on third postoperative week, and more advanced stage on sixth postoperative week. Sonographic examination identified in both forelimbs the presence of the induced membrane one week after the surgery. Histologically, there were no statistically significant differences in semi-quantitative score of inflammation intensity, total number of blood vessels, bone metaplasia and collagen. The average thickness of the induced membranes was 2050.17 µm and 1451.96 µm in the control forelimb and 2724.26 µm and 2081.03 µm in the laser irradiated limb, respectively on third and sixth postoperative weeks. VEGF and PDGF expression were present in the induced membranes of the control and irradiated forelimbs, but showed no significant difference. In conclusion, based on assessment methods was not possible to demonstrate statistically the influence of low-intensity laser irradiation in the Masquelet membrane.
This study aimed to evaluate the influence of low-intensity laser irradiation on the development and characteristics of the Masquelet membrane induced in orthotopic site in rabbits. Twelve Norfolk rabbits, mean age of 3 months were used. In both forelimbs, a segmental bone defect of 1.0 cm length was induced in the radius, which was filled with a cylinder of polymethylmethacrylate bone cement. Low-level laser therapy was used postoperatively in the bone defect of one of the forelimbs by point technique (2J energy) every 48 hours for 15 days. The bone defect were evaluated by ultrasound and radiographic examinations. Six rabbits were submitted to euthanasia at three weeks postoperatively and six rabbits at six weeks postoperatively to perform the histological and immunohistochemical examinations of the Masquelet’s membranes. In both forelimbs, radiographs showed new bone growth from the cut ends of the radius on third postoperative week, and more advanced stage on sixth postoperative week. Sonographic examination identified in both forelimbs the presence of the induced membrane one week after the surgery. Histologically, there were no statistically significant differences in semi-quantitative score of inflammation intensity, total number of blood vessels, bone metaplasia and collagen. The average thickness of the induced membranes was 2050.17 µm and 1451.96 µm in the control forelimb and 2724.26 µm and 2081.03 µm in the laser irradiated limb, respectively on third and sixth postoperative weeks. VEGF and PDGF expression were present in the induced membranes of the control and irradiated forelimbs, but showed no significant difference. In conclusion, based on assessment methods was not possible to demonstrate statistically the influence of low-intensity laser irradiation in the Masquelet membrane.
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Palavras-chave
Ortopedia, Infravermelho, Laserterapia, Fatores de crescimento ósseo, Defeito ósseo, Orthopedics, Infrared, Laser therapy, Growth factors, Bone defect