Journal of Orthopedic Research & Physiotherapy Category: Medical Type: Research Article
The Effect of Ultra-High Frequency Electromagnetic Radiation on Reparative Osteogenesis and Angiogenesis under Transosseous Osteosynthesis
- Iryanov Yu M1*, Sazonova NV1, Kiryanov NA2
- 1 Russian Ilizarov Scientific Center Restorative Traumatology And Orthopaedics, Kurgan, Russian Federation
- 2 Izhevsk State Medical Academy, Russian Federation
*Corresponding Author:Iryanov Yu M
Russian Ilizarov Scientific Center Restorative Traumatology And Orthopaedics, Kurgan, Russian Federation
Received Date: May 07, 2015 Accepted Date: Jul 18, 2015 Published Date: Aug 03, 2015
Purpose of the study: To study the efficiency of using low-intensive ultra-high frequency electromagnetic radiation in order to promote reparative osteogenesis and angiogenesis during fracture treatment under transosseous osteosynthesis making a qualitative and quantitative morphological analysis.
Materials and methods: Tibial fracture was modeled in the experiment on rats in control and experimental groups with reposition and fixation of the bone fragments. In experimental animals the fracture zone was exposed to low intensity electromagnetic radiation of ultra-high frequency. Exposure simulation was performed in the control group. The operated bones were examined using radiography, light and electronic microscopy, X-ray electron probe microanalysis.
Results: Electromagnetic radiation of ultra-high frequency in fracture treatment was proved to stimulate secretory activity and degranulation of mast cells, to produce the increase in microcirculatory bed vascular permeability, endotheliocyte migration phenotype expression, to ensure endovascular endothelial outgrowth, to activate reparative osteogenesis and angiogenesis while fracture reparation becomes one of the primary type and of a short-term duration. The content of bone tissue in the zone of fracture has been demonstrated to exceed the control values by 74%, 89% and 75%, respectively, 7, 14 and 28 days after surgery when exposed to low-intensive electromagnetic radiation of ultra-high frequency.
Conclusion: Mast cell secretory activity stimulation and endovascular angiogenesis activation is one of the therapeutic action mechanisms of ultra-high frequency electromagnetic radiation during fracture treatment.
PURPOSE OF THE STUDY
MATERIAL AND METHODS
DETAILED MEDICAL INTERVENTION
METHODS OF THE STUDY
METHODS OF A STATISTICAL ANALYSIS
The regenerated bone locating all over the diameter of the fragmental ends was clearly determined by X-rays in the operated bone of the animals from the experimental group seven (7) days after surgery and three sessions of UHF-therapy.
An active process of bone formation was observed which expressed itself in mass proliferation of periosteal and endosteal cambial osteogenic cells, as well as in formation of significant in volume periosteal and endosteal bone-osteoid areas of overgrowth overlapping the diastasis. Newly formed trabeculae of reticulofibrous bone tissue anastomosed and grew towards each other from the periosteal and endosteal surface. Multiple blood vessels and cells at different stages of osteogenic differentiation located between bone trabeculae. The mast cells of spindle- and sprout-like shape at different stages of degranulation process located along blood vessels (Figures 1a and b) which had a significant number of specific cytoplasmic large granules of homogenous electron-dense and grainy structure, many of which located directly below the cytoplasmic membrane. Herewith, partial disintegration of the granules was observed with their content coming out into the extracellular medium due to exocytosis. The signs of increased permeability of the endothelial layer were registered in the vessels of microcirculatory bed localized near the mast cells as evidenced by a large number of micropinocytic vesicles, the dissociation of endothelial contacts and the emergence of interendothelial pores and slots on the luminal surface. At the same time, capillary buds as endovasal endothelial outgrowths were revealed in the lumen of vessels (Figures 1c and d).
Figure 1: The areas of tibial regenerated bones seven (7) days after the fracture occurrence and performing three (3) sessions of ultra-high frequency electromagnetic radiation impact.
?,b - mast cells at the stage of degranulation: ? - scanning electron microscopy, magnification x 5000; b - an ultra-thin section, transmission electron microscopy, magnification x 8000;
c,d - endovasal endothelial outgrowths (arrows) at different stages of formation: ? - scanning electron microscopy, magnification x 3000; d - an ultra-thin section, transmission electron microscopy, magnification x 5000
The results of electron probe microanalysis (Table 1) evidenced of significant osteogenesis activation and the increase in the maturity degree of newly formed bone tissue in the regenerated bones of the experimental group animals comparing with those of the control one. It is clear from the table that bone tissue content after UHF-therapy was 172.3% and the index of compactness - 200% of the values in the animals from the control group.
|Parameters||Period of experiment, days|
|Bone tissue, %||18.42 ± 0.91||31.74 ± 1.531||30.45 ± 1.52||57.56 ± 2.111||45.34 ± 2.33||79.37 ± 3.961|
|Index of compactness||0.23 ± 0.01||0.46 ± 0.021||0.44 ± 0.02||1.36 ± 0.0721||0.83 ± 0.13||3.85 ± 0.211|
The signs of the initial stage of periosteal union being formed as a result of enchondral osteogenesis appeared in the control group of animals 14 days after surgery (Figure 2a).
Hyaline and fibrous cartilaginous tissue dominated between the fragments, as well as dense fibrous connective tissue. Fracture union occurred by the secondary type with formation of mainly periosteal callus which was presented by a network of interweaving bone trabeculae of different maturity degree formed as a result of enchondral osteogenesis. Primary osteons being formed were determined.
14 days after surgery the bone fragments in the experimental group of animals connected by periosteal-and-endosteal bone structures in the form of vertical brackets. In the intermediate zone the regenerated bone represented by cancellous bone tissue tightly welded together with fragmental ends (Figure 2b). Multiple blood vessels and perivascular mast cells located in intertrabecular spaces, where reorganization of cytoplasmic granules, as well as their contents releasing to the extracellular space was observed. An important feature of mast cells in this period of the experiment consisted in the fact that they had large granules of low electron density and vacuole-like structures. Numerous endovasal endothelial outgrowths at different stages of canalization with characteristic imbricate surface microrelief formed by flat marginal areas of adjacent endotheliocytes were found in the lumens of capillaries and venules adjacent to degranulated mast cells (Figure 2c). Functionally active osteoclasts located on the periosteal and endosteal surface of the fragments, and significant stratifications of newly formed bone trabeculae surrounded by numerous large osteoblasts were observed.
As electron probe microanalysis revealed, bone tissue content in the regenerated bones was 189% and the index of compactness - 309% of the values in the animals from the control group 14 days after fracture occurrence and performing six (6) sessions of UHF-therapy (see table 1).
The formation of a new cortical bone layer noted in the both groups of animals 28 days after surgery (Figure 3). The intermediate regenerated bone was clearly defined in the animals from the control group, bone thickening was observed in the zone of injury due to remaining periosteal stratifications of 1.5-2mm which compactized and united the ends of fragments as a fusiform coupler (Figure 3?). The regenerated bone in the intermediate zone is represented by spongy and compact bone tightly adhered to the cortical layer of bone fragments. There were foci of forming primary osteons deprived of ordered structure and orientation.
In this period of the experiment calcium and phosphorus content in the regenerated bones of the animals from the control group reached 81.04% and 91.27%, respectively, of the level of the values in the shaft cortical layer of intact animals (Table 2).
|Sodium||0.41 ± 0.02||0.35 ± 0.02||0.30 ± 0.02|
|Magnesium||0.32 ± 0.01||0.28 ± 0.01||0.22 ± 0.01|
|Phosphorus (?)||11.51 ± 0.62||12.14 ± 0.72||12.61 ± 0.72|
|Sulfur||0.23 ± 0.01||0.30 ± 0.02||0.34 ± 0.02|
|Calcium (??)||20.82 ± 1.31||25.67 ± 1.421||26.92 ± 1.42|
|??/?||1.81 ± 0.05||2.11 ± 0.06||2.13 ± 0.06|
Full contact of bone fragments in the zone of fracture was observed in experimental animals 28 days after surgery and 12 sessions of UHF-therapy. Complete periosteal, intermediate, and endosteal bone union was revealed throughout the width of the fragments (Figure 3b). Fracture healing occurred by the type of primary one. The ends of the fragments were connected by the secondary osteons of lamellar bone tissue of different maturity degree with compactization scenes. The expanded osteon canals were observed with growing new blood vessels into them. The content of bone tissue in regenerated bones almost 2-fold, and the index of compactness - more than 4-fold exceeded the similar parameters in the control group of animals (Table 1). The newly formed cortical layer did not practically differ in the degree of mineralization from the shaft cortical layer of intact animals. Calcium content in it was 95.17%, and that of phosphorus - 96.03% of the level of the parameters of cortical diaphysis of intact animals (Table 2).
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Citation:Iryanov YM, Sazonova NV, Kiryanov NA (2015) The Effect of Ultra-High Frequency Electromagnetic Radiation on Reparative Osteogenesis and Angiogenesis under Transosseous Osteosynthesis. J Orthop Res Physiother 1: 010.
Copyright: © 2015 Iryanov Yu M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.