Skip to main content

Advertisement

SpringerLink
Log in

Effect of low-level laser therapy on healing of tenotomized Achilles tendon in streptozotocin-induced diabetic rats

  • Original Article
  • Published:
Lasers in Medical Science Aims and scope Submit manuscript

Abstract

Diabetes mellitus (DM) is associated with musculoskeletal damage. Investigations have indicated that healing of the surgically tenotomized Achilles tendon was considerably augmented following low-level laser therapy (LLLT) in non-diabetic, healthy animals. The aim of the present study was to evaluate the effect of LLLT on the Achilles tendon healing in streptozotocin-induced diabetic (STZ-D) rats via a biomechanical evaluating method. Thirty-three rats were divided into non-diabetic (n = 18) and diabetic (n = 15) groups. DM was induced in the rats by injections of STZ. The right Achilles tendons of all rats were tenotomized 1 month after STZ injections. The two experimental groups (n = 6 for each group) of non-diabetic rats were irradiated with a helium–neon (He–Ne) laser at 2.9 and 11.5 J/cm2 for ten consecutive days. The two experimental groups of diabetic rats (n = 5 for each group) were irradiated with a He–Ne laser at 2.9 and 4.3 J/cm2 for ten consecutive days. The tendons were submitted to a tensiometric test. Significant improvements in the maximum stress (MS) values (Newton per square millimeter) were found following LLLT at 2.9 J/cm2 in both the non-diabetic (p = 0.031) and diabetic (p = 0.019) experimental groups when compared with their control groups. LLLT at 2.9 J/cm2 to the tenotomized Achilles tendons in the non-diabetic and diabetic rats significantly increased the strength and MS of repairing Achilles tendons in our study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Kemmis K (2010) Common musculoskeletal disorders in older adults with diabetes. Top Geriatr Rehabil 26:264–272

    Google Scholar 

  2. Perkins I (2004) Diabetes mellitus epidemiology—classification, determinants and public health impacts. J Miss State Med Assoc 45:355–362

    PubMed  Google Scholar 

  3. Boyle JP, Thompson TJ, Gregg EW, Barker LE, Williamson DF (2010) Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence. Popul Health Metr 8:29–41

    Article  PubMed  Google Scholar 

  4. Ramchurn N, Mashamba C, Leitch E, Arutchelvam V, Narayanan K, Weaver J, Hamilton J, Heycock C, Saravanan V, Kelly C (2009) Upper limb musculoskeletal abnormalities and poor metabolic control in diabetes. Eur J Intern Med 20:718–721

    Article  PubMed  Google Scholar 

  5. Cagliero E, Apruzzese W, Perlimutter G, Nathan DM (2002) Musculoskeletal disorders of the hand and shoulder in patients with diabetes mellitus. Am J Med 20:718–721

    Google Scholar 

  6. Chaturvedi N (2007) The burden of diabetes and its complications: trends and implications for intervention. Diabetes Res Clin Pract 76(suppl 1):S3–S12

    Article  PubMed  Google Scholar 

  7. Marks RM (2001) Complications of foot and ankle surgery in patients with diabetes. Clin Orthop Relat Res 391:153–161

    Article  PubMed  Google Scholar 

  8. Ganesh SP, Pietrobon R, Cecilio WA, Pan D, Lightdale N, Nunley JA (2005) The impact of diabetes on patient outcomes after ankle fracture. J Bone Joint Surg Am 87:1712–1718

    Article  PubMed  Google Scholar 

  9. Akturk M, Karaahmetoglu S, Kacar M, Muftuoglu O (2002) Thickness of the supraspinatous and biceps tendons in diabetic patients. Diabet Care 25:408

    Article  Google Scholar 

  10. Smith LL, Burnet SP, Mc Neil JD (2003) Musculoskeletal manifestations of diabetes mellitus. Br J Sports Med 37:30–35

    Article  CAS  PubMed  Google Scholar 

  11. Lin TW, Gardenas L, Soslowsky LJ (2004) Biomechanics of tendon injury and repair. J Biochem 37:865–877

    Google Scholar 

  12. Mavrikakis ME, Drimis S, Kontoyannis DA, Rasidakis A, Moulolpoulou ES, Kontoyannis S (1989) Calcific shoulder periarthritis (tendinitis) in adult onset diabetes mellitus: a controlled study. Ann Rheum Dis 48:211–214

    Article  CAS  PubMed  Google Scholar 

  13. Akturk M, Ozdemir A, Maral I, Yektin I, Arslan M (2007) Evaluation of Achilles tendon thickening in type 2 diabetes mellitus. Exp Clin Endocrinol Diabetes 115:92–96

    Article  CAS  PubMed  Google Scholar 

  14. Chen AL, Shapiro JA, Ahn AK, Zuckerman JD, Cuomo F (2003) Rotator cuff repair in patients with type 1 diabetes mellitus. J Shoulder Elbow Surg 12:416–421

    Article  PubMed  Google Scholar 

  15. Bruggeman NB, Turner NS, Dahm DL, Voll AE, Hoskin TL, Jacofsky DJ, Haidukewych GJ (2004) Wound complications after open Achilles tendon repair: an analysis of risk factors. Clin Orthop Relat Res 427:63–66

    Article  PubMed  Google Scholar 

  16. Didomenico LA, Williams K, Petrolla AF (2008) Spontaneous rupture of the anterior tibial tendon in a diabetic patient: results of operative treatment. J Food Ankle Surg 47:463–467

    Article  Google Scholar 

  17. Maffulli N, Longo UG, Maffulli GD, Khanna A, Denaro V (2011) Achilles tendon ruptures in diabetic patients. Arch Orthop Trauma Surg 131:33–38

    Article  PubMed  Google Scholar 

  18. Chbinou N, Frenette J (2004) Insulin dependent diabetes impairs the inflammatory response and delays angiogenesis following Achilles tendon injury. Am J Physiol Regul Integr Comp Physiol 286:R952–R957

    Article  CAS  PubMed  Google Scholar 

  19. Bedi A, Fox AJ, Harris PE, Deng XH, Ying L, Warren RF, Rodeo SA (2010) Diabetes mellitus impairs tendon-bone healing after rotator cuff repair. J Shoulder Elbow Surg 19:978–988

    Article  PubMed  Google Scholar 

  20. Bayat M, Feridoni MJ, Piryaie A, Dadpay M, Gazour R, Rezaei F, Norouzian M, and Akbari M (2012) Effect of streptozotocin induced type-1 diabetes on tendon healing in rats, a biomechanical and histological study. Int J Diabetes Mellit (in press)

  21. Reddy GK (2004) Photobiological basis and clinical role of low-intensity lasers in biology and medicine. J Clin Laser Med Surg 22:141–150

    Article  PubMed  Google Scholar 

  22. Mester E, Juhasz J, Veraga P, Karika G (1968) Laser in clinical practice. Acta Chir Acad Sci Hung 9:349–357

    CAS  PubMed  Google Scholar 

  23. Enwemeka CS, Rodriguez O, Gall NG, Walsh NE (1990) Morphometric of collagen fibril population in He–Ne laser photostimulated tendons. J Clin Laser Med Surg 8:47–51

    Google Scholar 

  24. Enwemeka CS (1991) Connective tissue plasticity: ultrastructural, biomechanical, and morphometric effects of physical factors on intact and regenerating tendons. J Orthop Sports Phys Ther 14:198–212

    CAS  PubMed  Google Scholar 

  25. Enwemeka CS (1992) Ultrastructural morphometry of membrane-bound intracytoplasmic collagen fibrils in tendon fibroblasts exposed to He–Ne laser beam. Tissue Cell 24:511–523

    Article  CAS  PubMed  Google Scholar 

  26. Reddy GK (2003) Comparison of the photostimulatory effects of visible He–Ne and infrared Ga–As lasers on healing impaired diabetic rat wounds. Lasers Surg Med 33:344–351

    Article  PubMed  Google Scholar 

  27. Fox AJ, Bedi A, Deng SH, Ying L, Harris PE, Warren RF, Rodeo SA (2011) Diabetes mellitus alters the mechanical properties of the native tendon in an experimental rat model. J Orthop Res 29:880–885

    Article  PubMed  Google Scholar 

  28. Reddy GK, Stehno-Bittel L, Enwemeka CS (1998) Laser photostimulation of collagen production in healing rabbit Achilles tendon. Lasers Surg Med 22:281–287

    Article  CAS  PubMed  Google Scholar 

  29. Elwakil TF (2007) An in vivo experimental evaluation of He–Ne laser photostimulation in healing Achilles tendons. Laser Med Sci 23:53–59

    Article  Google Scholar 

  30. Carrinho PM, Renno AC, Koeke P, Salate ACB, Parizotto NA, Vidal BC (2006) Comparative study using 685-nm and 830-nm lasers in tissue repair of tenotomized tendons in the mouse. Photomed Laser Surg 24:754–758

    Article  PubMed  Google Scholar 

  31. Reddy GK, Stenho-Bittel L, Enwemeka CS (2001) Laser photostimulation accelerates wound healing in diabetic rats. Wound Rep Reg 9:248–255

    Article  CAS  Google Scholar 

  32. Bayat M, Abdi S, Javadieh F, Mohsenifar ZH, Rashid MR (2009) The effects of low-level laser therapy on bone in diabetic and non diabetic rats. Photomed Laser Surg 27:703–708

    Article  PubMed  Google Scholar 

  33. Lin JH, Wang MX, Wei A, Zhu W, Diwan AD, Murrell GA (2001) Temporal expression of nitric oxide synthesis isoforms in healing Achilles tendon. J Orthop Res 19:136–142

    Article  CAS  PubMed  Google Scholar 

  34. Zhang F, Liu H, Stile F, Lei MP, Pang Y, Oswaldt TM, Beck J, Dorsett-Martin W, Lineaweaver WC (2003) Effect of vascular endothelial growth factor on rat Achilles tendon healing. Plast Reconstr Surg 112:1613–1619

    Article  PubMed  Google Scholar 

  35. Enwemeka CS (2009) Intricacies of dose in laser phototherapy for tissue repair and pain relief. Photomed Laser Surg 27:387–393

    Article  PubMed  Google Scholar 

  36. Yuan J, Murrel GA, Wei AQ, Appleyard RC, DelSoldato P, Wang MX (2003) Addition of nitric oxide via nitroflurbiprofen enhances the material properties of early healing of young rat Achilles tendons. Inflamm Res 52:230–237

    Article  CAS  PubMed  Google Scholar 

  37. Demir H, Menku P, Kirnap M, Calis M, Ikizceli I (2004) Comparison of the effects of laser, ultrasound and combined laser + ultrasound treatments in experimental tendon healing. Lasers Surg Med 35:84–89

    Article  PubMed  Google Scholar 

  38. Karu TI (1990) Effect of visible radiation on cultured cells. Photochem Photobiol 52:1089–1098

    Article  CAS  PubMed  Google Scholar 

  39. Steinlechner C, Dyson M (1993) The effect of low-level laser therapy on the proliferation of keratinocytes. Laser Ther 5:65–73

    Article  Google Scholar 

  40. Fillipin LI, Mauriz JL, Vedovelli K, Moreira AJ, Zettler CG, Lech O, Marroni NP, Gonzalez-Gallego J (2005) Low-level laser therapy (LLLT) prevents oxidative stress and reduces fibrosis in rat traumatized Achilles tendon. Lasers Surg Med 37:293–300

    Article  PubMed  Google Scholar 

  41. Pires D, Xavier M, Araujo T, Silva JA Jr, Aimbire F, Albertini R (2011) Low-level laser therapy (LLLT, 780 nm) acts differently on mRNA expression of anti- and pro-inflammatory mediators in an experimental model of collagenase-induced tendinitis in rat. Lasers Med Sci 26:85–94

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We wish to extend our sincere thanks to the late Mrs. Jamileh Rezaei and the Vice-Chancellor of Research at the Medical Faculty of Shaheed Beheshti University MC, Tehran, Iran for financial support (grant no. 13.15183).

Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Anatomical sciences and Biology, Medical Faculty, Shahid Beheshti University, MC, PO Box 19395/4719, Tehran, 1985717443, Iran

    Mohsen Nouruzian, Morteza Alidoust & Mohammad Bayat

  2. Dentistry Faculty, Tehran University of Medical Sciences, Tehran, Iran

    Mehernoush Bayat

  3. Department of Physical Therapy, Faculty of Welfare and Rehabilitative Sciences, Tehran University of Medical Sciences, Tehran, Iran

    Mohammad Akbari

Authors
  1. Mohsen Nouruzian
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Morteza Alidoust
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohammad Bayat
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mehernoush Bayat
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mohammad Akbari
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mohammad Bayat.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nouruzian, M., Alidoust, M., Bayat, M. et al. Effect of low-level laser therapy on healing of tenotomized Achilles tendon in streptozotocin-induced diabetic rats. Lasers Med Sci 28, 399–405 (2013). https://doi.org/10.1007/s10103-012-1074-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10103-012-1074-7

Keywords

Search

Navigation