nach oben

Erschienen in:

16.06.2018 | Original Article

Photobiomodulation therapy (PBMT) on acute pain and inflammation in patients who underwent total hip arthroplasty—a randomized, triple-blind, placebo-controlled clinical trial

verfasst von: Luciana Gonçalves Langella, Heliodora Leão Casalechi, Shaiane Silva Tomazoni, Douglas Scott Johnson, Regiane Albertini, Rodney Capp Pallotta, Rodrigo Labat Marcos, Paulo de Tarso Camillo de Carvalho, Ernesto Cesar Pinto Leal-Junior

Erschienen in: Lasers in Medical Science | Ausgabe 9/2018

Einloggen, um Zugang zu erhalten

Abstract

When conservative treatments fail, hip osteoarthritis (OA), a chronic degenerative disease characterized by cartilage wear, progressive joint deformity, and loss of function, can result in the need for a total hip arthroplasty (THA). Surgical procedures induced tissue trauma and incite an immune response. Photobiomodulation therapy (PBMt) using low-level laser therapy (LLLT) and/or light-emitting diode therapy (LEDT) has proven effective in tissue repair by modulating the inflammatory process and promoting pain relief. Therefore, the aim of this study was to analyze the immediate effect of PBMt on inflammation and pain of patients undergoing total hip arthroplasty. The study consisted of 18 post-surgical hip arthroplasty patients divided into two groups (n = 9 each) placebo and active PBMt who received one of the treatments in a period from 8 to 12 h following THA surgery. PBMt (active or placebo) was applied using a device consisting of nine diodes (one super-pulsed laser of 905 nm, four infrared LEDs of 875 nm, and four red LEDs 640 nm, 40.3 J per point) applied to 5 points along the incision. Visual analog scale (VAS) and blood samples for analysis of the levels of the cytokines TNF-α, IL-6, and IL-8 were recorded before and after PBMt application. The values for the visual analog scale as well as those in the analysis of TNF-α and IL-8 serum levels decreased in the active PBMt group compared to placebo-control group (p < 0.05). No decrease was observed for IL-6 levels. We conclude that PBMt is effective in decreasing pain intensity and post-surgery inflammation in patients receiving total hip arthroplasty.

Brandt KD, Dieppe P, Radin E (2009) Etiopathogenesis of osteoarthritis. Med Clin North Am 93:1–24CrossRef

Bondeson J, Blom AB, Wainwright S, Hughes C, Caterson B, Van den Berg WB (2010) The role of synovial macrophages and macrophage-produced mediators in driving inflammatory and destructive responses in osteoarthritis. Arthritis Rheum 62:647–657CrossRef

Da Rosa AS, dos Santos AF, da Silva MM, Facco GG, Perreira DM, Alves AC, Leal Junior EC, de Carvalho Pde T (2012) Effects of low-level laser therapy at Wavelenghts of 660 and 808 nm in experimental model of osteoarthritis. Photochem Photobiol 88:161–166CrossRef

Corti CM, Rigon C (2003) Epidemiology of osteoarthritis: prevalence risk factors and functional impact. Aging Clin Exp Res 15:359–363CrossRef

Taylor A, Stanbury L (2009) A review of postoperative pain management and the challenges. Curr Anaesth Crit Care 20:188–194CrossRef

Zavadak KH, Gibson KR, Wititley DM, Britz P, Kwoh CK (1995) Variability in the attainment of functional milestones during the care admission after total joint replacement. J Rheumatol 22:482–487PubMed

Hawker GA, Wright JG, Coyte PC, Williams JI, Harvey B, Glazier R (2001) Determining the need for hip and knee arthroplasty: the role of clinical severity and patients preferences. Med Care 39:206–216CrossRef

Beloosesky Y, Hendel D, Weiss A, Heishkovitz A, Grinblat J, Pirotsky A, Barak V (2007) Cytokines and C-reactive protein production in hip-fracture-operated elderly patients. J Gerontol A Biol Sci Med Sci 62:420–426CrossRef

Shah K, Mohammed A, Patil S, McFadyen A, Meek RMD (2009) Circulating cytokines after hip and knee arthroplasty: a preliminary study. Clin Orthop Relat Res 467:946–951CrossRef

10.

Kwak S, Chun Y, Rhyu K, Cha J, Cho Y (2014) Quantitative analysis of tissue injury after minimally invasive Total hip arthroplasty. Clin Orthop Surg 6:279–284CrossRef

11.

Reikeras O, Borgen P, Reselandand JE, Lyngstadaas SP (2014) Changes in serum cytokines in response to musculoskeletal surgical trauma. BMC Res Notes 7:128–132CrossRef

12.

Ferreira CHJF, Beleza ACS (2007) Abordagem fisioterapêutica da dor pós-operatória. Rev Col Bras Surg 34:127–130CrossRef

13.

Morrison RS, Magaziner J, McLaughlin MA, Orosz G, Silberzweig SB, Koval KJ, Siu AL (2003) The impact of post-operative pain on outcomes following hip fracture. Pain 103:303–311CrossRef

14.

Joelsson M, Olsson LE, Jakobsson E (2010) Patients’ experience of pain and pain relief following hip replacement surgery. J Clin Nurs 19:2832–2838CrossRef

15.

Giannoudis PV, Hak D, Sanders D, Donohoe E, Tosounidis T, Bahney C (2015) Inflammation, bone healing, and anti-inflammatory drugs: an update. J Orthop Trauma 29:S6–S9CrossRef

16.

Jin J (2015) JAMA PATIENT PAGE. Nonsteroidal anti-inflammatory drugs. JAMA 314:1084CrossRef

17.

Alves ACA, Vieira RP, Leal Junior EC, dos Santos AS, Ligeiro AP, Albertini R, Silva Junior JA, de Carvalho PTC (2013) Effect of low-level laser therapy on the expression of inflammatory mediators and on neutrophils and macrophages in acute joint inflammation. Arthritis Res Ther 15:R116CrossRef

18.

Pallotta RC, Bjordal JM, Frigo L, Leal Junior EC, Teixeira S, Marcos RL, Ramos L, Messias Fde M, Lopes-Martins RA (2011) Infrared (810-nm) low-level laser therapy on rat experimental knee inflammation. Lasers Med Sci 27:71–78CrossRef

19.

Herpich CM, Leal-Junior ECP, Gomes CAFP, Gloria IPDS, Amaral AP, Amaral MFRS, Politti F, Biasotto-Gonzalez DA (2017) Immediate and short-term effects of phototherapy on pain, muscle activity, and joint mobility in women with temporomandibular disorder: a randomized, double-blind, placebo-controlled, clinical trial. Disabil Rehabil

20.

Helrigle C, Pd DC, Casalechi HL, Leal-Junior EC, Fernandes GH, Helrigel PA, Rabelo RL, De Oliveira Aleixo-Junior I, Aimbire F, Albertini R (2016) Effects of low-intensity non-coherent light therapy on the inflammatory process in the calcaneal tendon of ovariectomized rats. Lasers Med Sci 31:33–40CrossRef

21.

Dos Santos SA, Alves ACA, Leal Junior EC, Albertini R, Vieira RP, Ligeiro AP, Silva Junior JA, de Carvalho PTC (2014) Comparative analysis of two low-level laser doses on the expression of inflammatory mediators and on neutrophis and macrophages in acute joint inflamation. Lasers Med Sci 29:1051–1058PubMed

22.

Casalechi HL, de Farias Marques AC, da Silva EAP, Aimbire F, Marcos RL, Lopes-Martins RAB, de Carvalho Pde T, Albertini R (2014) Analysis of the effect of phototherapy in model with traumatic Achilles tendon injury in rats. Lasers Med Sci 12:1075–1081CrossRef

23.

Carvalho Pde T, Silva IS, Reis FA, Belchior AC, Facco GG, Guimarães RN, Fernandes GH, Denadai AS (2006) Effect of 650 nm low-power laser on bone morphogenetic protein in bone defects induced in rat femors. Acta Cir Bras 21:63–68CrossRef

24.

De Almeida P, Lopes-Martins RÁ, Tomazoni SS, Albuquerque-Pontes GM, Santos LA, Vanin AA, Frigo L, Vieira RP, Albertini R, de Carvalho Pde T, Leal-Junior EC (2013) Low-level laser therapy and sodium diclofenac in acute inflammatory response induced by skeletal muscle trauma: effects in muscle morphology and mRNA gene expression of inflammatory markers. Photochem Photobiol 89:501–507CrossRef

25.

De Almeida P, Tomazoni SS, Frigo L, de Carvalho Pde T, Vanin AA, Santos LA, Albuquerque-Pontes GM, De Marchi T, Tairova O, Marcos RL, Lopes-Martins RÁ, Leal-Junior EC (2014) What is the best treatment to decrease pro-inflammatory cytokine release in acute skeletal muscle injury induced by trauma in rats: low-level laser therapy, diclofenac, or cryotherapy? Lasers Med Sci 29:653–658CrossRef

26.

Tomazoni SS, Frigo L, Dos Reis Ferreira TC, Casalechi HL, Teixeira S, de Almeida P, Muscara MN, Marcos RL, Serra AJ, de Carvalho PTC, Leal-Junior ECP (2017) Effects of photobiomodulation therapy and topical non-steroidal anti-inflammatory drug on skeletal muscle injury induced by contusion in rats-part 1: morphological and functional aspects. Lasers Med Sci 32:2111–2120CrossRef

27.

Tomazoni SS, Frigo L, Dos Reis Ferreira TC, Casalechi HL, Teixeira S, de Almeida P, Muscara MN, Marcos RL, Serra AJ, de Carvalho PTC, Leal-Junior ECP (2017) Effects of photobiomodulation therapy and topical non-steroidal anti-inflammatory drug on skeletal muscle injury induced by contusion in rats-part 2: biochemical aspects. Lasers Med Sci 32:1879–1887CrossRef

28.

Ramos L, Leal Junior EC, Pallotta RC, Frigo L, Marcos RL, de Carvalho MH, Bjordal JM, Lopes-Martins RÁ (2012) Infrared (810 nm) low-level laser therapy in experimental model of strain-induced skeletal muscle injury in rats: effects on functional outcomes. Photochem Photobiol 88:154–160CrossRef

29.

Tomazoni SS, Leal-Junior EC, Frigo L, Pallotta RC, Teixeira S, de Almeida P, Bjordal JM, Lopes-Martins RÁ (2016) Isolated and combined effects of photobiomodulation therapy, topical nonsteroidal anti-inflammatory drugs, and physical activity in the treatment of osteoarthritis induced by papain. J Biomed Opt 21:108001CrossRef

30.

Tomazoni SS, Leal-Junior EC, Pallotta RC, Teixeira S, de Almeida P, Lopes-Martins RÁ (2017) Effects of photobiomodulation therapy, pharmacological therapy, and physical exercise as single and/or combined treatment on the inflammatory response induced by experimental osteoarthritis. Lasers Med Sci 32:101–108CrossRef

31.

Da Rosa AS, dos Santos AF, da Silva MM, Facco GG, Perreira DM, Alves AC, Leal Junior EC, de Carvalho Pde T (2012) Effects of low-level laser therapy at wavelengths of 660 and 808 nm in experimental model of osteoarthritis. Photochem Photobiol 88:161–166CrossRef

32.

Dos Santos SA, Alves AC, Leal-Junior EC, Albertini R, Vieira RP, Ligeiro AP, Junior JA, de Carvalho Pde T (2014) Comparative analysis of two low-level laser doses on the expression of inflammatory mediators and on neutrophils and macrophages in acute joint inflammation. Lasers Med Sci 29:1051–1058PubMed

33.

Marcos RL, Leal Junior EC, Messias Fde M, de Carvalho MH, Pallotta RC, Frigo L, dos Santos RA, Ramos L, Teixeira S, Bjordal JM, Lopes-Martins RÁ (2011) Infrared (810 nm) low-level laser therapy in rat achilles tendinitis: a consistente alternative to drugs. Photochem Photobiol 87:1447–1452CrossRef

34.

Marcos RL, Leal-Junior EC, Arnold G, Magnenet V, Rahouadj R, Wang X, Demeurie F, Magdalou J, de Carvalho MH, Lopes-Martins RÁ (2012) Low-level laser therapy in collagenase-induced Achilles tendinitis in rats: analyses of biochemical and biomechanical aspects. J Orthop Res 30:1945–1951CrossRef

35.

Laraia EM, Silva IS, Pereira DM, dos Reis FA, Albertini R, de Almeida P, Leal Junior EC, de Tarso Camillo de Carvalho P (2012) Effect of low-level laser therapy (660 nm) on acute inflammation induced by tenotomy of Achilles tendon in rats. Photochem Photobiol 88:1546–1550CrossRef

36.

Bjordal JM, Ljunggren AE, Klovning A, Slørdal L (2004) Non-steroidal anti-inflammatory drugs, including cyclo-oxygenase-2 inhibitors, in osteoarthritic knee pain: meta-analysis of randomised placebo-controlled trials. Br Med J 329:1317CrossRef

37.

Bjordal J, Klovning A, Ljunggren A, Slørdal L (2007) Short-term efficacy of pharmacotherapeutic interventions in osteoarthritic knee pain: a meta-analysis of randomized placebo-controlled trials. Eur J Pain 11:125–138CrossRef

38.

Harris WH, Sledge CB (1990) Total hip and total knee replacement (first of two parts). N Engl J Med 323:725–731CrossRef

39.

Dejour H, Carret JP, Walch G (1991) Les Gonarthroses. In: 7émes Journées Lyonnaises de Chirurgie de Genou. Lyon

40.

Leal-Junior EC, Johnson DS, Saltmarche A, Demchak T (2014) Adjunctive use of combination of super-pulsed laser and light-emitting diodes phototherapy on nonspecific knee pain: double-blinded randomized placebo-controlled trial. Lasers Med Sci 29:1839–1847CrossRef

41.

Elkins MR, Moseley AM (2015) Intention-to-treat analysis. J Physiother 61:165–167CrossRef

42.

Oliveira SS, Melo DA, Mesquita FRA, Maia AP, Bussadori SK, Santos FKP (2013) Effect of low-level laser therapy on the post-surgical inflammatory process after third molar removal: study protocol for a double-blind randomized controlled trial. Trials 6:373CrossRef

43.

Merigo M, Vescovi P, Ricotti E, Stea S, Meleti M, Manfredi M, Fornaini C (2015) Efficacy of LLLT in swelling and pain control after the extraction of lower impacted third molars. Laser Ther 24:39–46CrossRef

44.

Fabre HS, Navarro RL, Oltramari-Navarro PV, Oliveira RF, Pires-Oliveira DA, Andraus RA, Fuirini N, Fernandes KB (2015) Anti-inflammatory and analgesic effects of low-level laser therapy on the postoperative healing process. J Phys Ther Sci 27:1645–1648CrossRef

45.

Nesioonpour S, Mokmeli S, Vojdani S, Mohtadi A, Akhondzadeh R, Behaeen K, Moosavi S, Hojjati S (2014) The effect of low-level laser on postoperative pain after tibial fracture surgery: a double-blind controlled randomized clinical trial. Anesth Pain Med 4:e17350PubMedPubMedCentral

46.

Nesioonpour S, Mokmeli S, Akhondzadeh R, Moosavi S, Mackie M, Naderan M (2014) Does low-level laser therapy enhance the efficacy of intravenous regional anesthesia? Pain Res Manag 19:154–158CrossRef

47.

Defu YU, Zongsheng YIN, Changma FU, Runze YU (2014) Impact on red blood cell immunity patterns in postoperative phase following total hip arthroplasty. Cent Eur J Immunol 39:377–383

Titel: Photobiomodulation therapy (PBMT) on acute pain and inflammation in patients who underwent total hip arthroplasty—a randomized, triple-blind, placebo-controlled clinical trial
verfasst von: Luciana Gonçalves Langella
Heliodora Leão Casalechi
Shaiane Silva Tomazoni
Douglas Scott Johnson
Regiane Albertini
Rodney Capp Pallotta
Rodrigo Labat Marcos
Paulo de Tarso Camillo de Carvalho
Ernesto Cesar Pinto Leal-Junior
Publikationsdatum: 16.06.2018
Verlag: Springer London
Erschienen in: Lasers in Medical Science / Ausgabe 9/2018
Print ISSN: 0268-8921
Elektronische ISSN: 1435-604X
DOI: https://doi.org/10.1007/s10103-018-2558-x

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 9/2018

Evaluation of the effects of Er:YAG laser, Nd:YAG laser, and two different desensitizers on dentin permeability: in vitro study

Comparative study of the effect of Er:YAG and Er:Cr;YSGG lasers on porcelain: etching for the bonding of orthodontic brackets

Photobiomodulation therapy reduces viral load and cell death in ZIKV-infected glioblastoma cell line

Correction to: Glucose in Conjunction with Multiple Laser Pulses on Laser Treatment of Port-wine Stain: An in vivo Study

Low-level laser therapy combined to functional exercise on treatment of fibromyalgia: a double-blind randomized clinical trial

Photobiomodulation on critical bone defects of rat calvaria: a systematic review