Abstract

PurposeThe meta-analysis was performed to identify animal research defining the effects of low power laser irradiation on biomechanical indicators of bone regeneration and the impact of dosage.MethodsWe searched five electronic databases (MEDLINE, EMBASE, PubMed, CINAHL, and Cochrane Database of Randomised Clinical Trials) for studies in the area of laser and bone healing published from 1966 to October 2008. Included studies had to investigate fracture healing in any animal model, using any type of low power laser irradiation, and use at least one quantitative biomechanical measures of bone strength. There were 880 abstracts related to the laser irradiation and bone issues (healing, surgery and assessment). Five studies met our inclusion criteria and were critically appraised by two raters independently using a structured tool designed for rating the quality of animal research studies. After full text review, two articles were deemed ineligible for meta-analysis because of the type of injury method and biomechanical variables used, leaving three studies for meta-analysis. Maximum bone tolerance force before the point of fracture during the biomechanical test, 4 weeks after bone deficiency was our main biomechanical bone properties for the Meta analysis.ResultsStudies indicate that low power laser irradiation can enhance biomechanical properties of bone during fracture healing in animal models. Maximum bone tolerance was statistically improved following low level laser irradiation (average random effect size 0.726, 95% CI 0.08 - 1.37, p 0.028). While conclusions are limited by the low number of studies, there is concordance across limited evidence that laser improves the strength of bone tissue during the healing process in animal models.

Highlights

  • Bone and fracture healing is an important homeostatic process that depends on specialized cell activation and bone immobility during injury repair [1,2]

  • Most studies have concentrated on drugs, fixation methods or surgical techniques; there is a potential role for adjunctive modalities that affect the bone-healing process

  • We evaluated the bias of publication via analysis option by Fail Safe N computation in Comprehensive Meta Analysis (CMA)

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Summary

Introduction

Bone and fracture healing is an important homeostatic process that depends on specialized cell activation and bone immobility during injury repair [1,2]. Fracture reduction and fixation are a prerequisite to healing but a variety of additional factors such as age, nutrition, and medical co-morbidities can mediate the healing process [3,4]. Different methods have been investigated in attempts to accelerate the bone-healing process. Most studies have concentrated on drugs, fixation methods or surgical techniques; there is a potential role for adjunctive modalities that affect the bone-healing process. Laser is an acronym for “Light Amplification by stimulated Emission of Radiation” [5]. The first laser was demonstrated in 1960 and since it has been used for surgery, diagnostics, and therapeutic medical

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