Ko Po-Yen, Hsu Che-Chia, Chen Shih-Yao, Hsu Chieh-Hsiang, Li Chia-Lung, Jou I-Ming, Wu Po-Ting
Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Nursing, College of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan.
Bone Joint Res. 2025 May 2;14(5):376-388. doi: 10.1302/2046-3758.145.BJR-2024-0285.R2.
This study aimed to evaluate the effects of Nd:YAG laser treatment on fracture healing in a rat model. We hypothesized that laser therapy would accelerate healing by stimulating early neovascularization and osteoblast recruitment.
A total of 54 male Sprague-Dawley rats received intramedullary Kirschner wire (K-wire) osteosynthesis following femoral osteotomy, and were randomly divided into two groups (n = 27 each): the control group, and the laser group that received daily pulsed Nd:YAG laser for ten days immediately after osteotomy. Fracture sites were assessed using micro-CT (μCT; n = 8 at each timepoint), histology (n = 4), and three-point bending tests (n = 4) at week 2, week 4 and week 6, respectively. At week 2, an additional three rats per group were selected for the western blot tests.
Compared to controls, the laser group showed higher vascular endothelial growth factor (VEGF), CD31, and Runx2 protein expression, and significantly higher neovascular area density and osteoblast density (p = 0.025 and p = 0.008, respectively) at week 2. At week 4, the laser treatment led to higher histological fracture healing scale and flexural modulus, and less strain (p = 0.001, p = 0.020, and p = 0.004, respectively). Macroscopically, the laser group showed higher mature bone volume fraction and radiological union score at weeks 4 and 6 (volume fraction: p = 0.017 and p = 0.001; union score: p = 0.001 and p = 0.024, respectively).
Pulsed Nd:YAG laser therapy accelerates multiple quantitative indicators of fracture healing within six weeks in a rat femoral osteotomy model, which was associated with enhanced angiogenesis and osteogenesis during the early healing phase.
本研究旨在评估钕钇铝石榴石(Nd:YAG)激光治疗对大鼠模型骨折愈合的影响。我们假设激光治疗可通过刺激早期新血管形成和成骨细胞募集来加速愈合。
总共54只雄性斯普拉格-道利大鼠在股骨截骨术后接受髓内克氏针(K针)内固定,并随机分为两组(每组n = 27):对照组和激光组,激光组在截骨术后立即每天接受脉冲Nd:YAG激光照射,持续10天。分别在第2周、第4周和第6周使用微型计算机断层扫描(μCT;每个时间点n = 8)、组织学检查(n = 4)和三点弯曲试验(n = 4)对骨折部位进行评估。在第2周,每组另外选取3只大鼠进行蛋白质印迹试验。
与对照组相比,激光组在第2周时血管内皮生长因子(VEGF)、CD31和Runx2蛋白表达更高,新血管面积密度和成骨细胞密度显著更高(分别为p = 0.025和p = 0.008)。在第4周,激光治疗导致更高的组织学骨折愈合等级和弯曲模量,以及更小的应变(分别为p = 0.001、p = 0.020和p = 0.004)。宏观上,激光组在第4周和第6周时成熟骨体积分数和放射学愈合评分更高(体积分数:p = 0.017和p = 0.001;愈合评分:分别为p = 0.001和p = 0.024)。
在大鼠股骨截骨模型中,脉冲Nd:YAG激光治疗可在六周内加速骨折愈合的多个定量指标,这与早期愈合阶段血管生成和成骨增强有关。