Uso do biopolímero de fibrina heterólogo associado ou não à fotobiomodulação no processo de reparo tendíneo

Abstract

Introduction: The tendons are susceptible to injuries, and the calcaneal tendon is frequently injured. However, there is much controversy about the treatment of tendon injuries. In this perspective, the use of heterologous fibrin biopolymer (HFB), a homeostatic agent that has been used in several types of surgeries and a surgical strategy for the treatment of tendon injuries. In addition, non-surgical treatment using laser photobiomodulation therapy (PBMT) has been shown to be effective in the repair process. Objective: To evaluate the effect of heterologous fibrin biopolymer associated or not with photobiomodulation in the tendon repair process. Methodology: 84 Rattus norvegicus belonging to the Wistar strain were used. The animals were randomly divided into 4 experimental groups with N=21 animals in each: Control (CG); Heterologous fibrin biopolymer (HFB); Photobiomodulation (PBM); Heterologous fibrin biopolymer + Photobiomodulation (HFB + PBM). The groups were subdivided into 3 experimental periods: 7, 14 and 21 days. The animals received HFB immediately after partial tendon transection. PBM started the lesion induction for 24 hours and was followed for 7, 14, 21 days. For PBM, a 660 nm, 40 mW, 0.23 J and 6 second laser was used. The volume of the edema was evaluated, immediately before the tendon transection; 24 hours after tendon transection; on the day of euthanasia, following their respective experimental periods. The descriptive histopathological analysis and through the Bonar scale in the partially transected tendon region and the quantification of blood vessels were performed using slides stained with Hematoxylin and Eosin (HE). Collagen quantification was performed using slides stained with Masson's trichrome. Results: The results of the edema volume showed that, 24 hours after partial transection of the calcaneus tendon, there was no statistical difference between the experimental groups. After the three experimental periods, it was observed that the treatment groups were effective in reducing edema when compared to control. A histological analysis revealed that PBM had a major tendon injury after 7 days. However, in the periods of 14 and 21 days, the PBM had a better repair process compared to the GC, while the HFB and HFB + PBM had a better repair process when compared to the GC in the 3 experimental periods. PBM showing a greater number of blood vessels after 7, 14 and 21 days. In the quantification of collagen, there was no statistical difference between the groups, in the 3 experimental periods. Conclusion: The results obtained with the HFB and PBM treatments, granted or associated, were effective in reducing the volume of the edema, stimulating the repair process. However, the use of HFB alone is more effective in promoting the tendon repair process. Thus, this study consolidates previous studies of tendon repair with this new HFB. Clinical futures will be included to validate this proposal.