Lasers in Medical Science

, Volume 30, Issue 9, pp 2335–2339 | Cite as

Does addition of low-level laser therapy (LLLT) in conservative care of knee arthritis successfully postpone the need for joint replacement?

  • David IpEmail author
Original Article


The current study evaluates whether the addition of low-level laser therapy into standard conventional physical therapy in elderly with bilateral symptomatic tri-compartmental knee arthritis can successfully postpone the need for joint replacement surgery. A prospective randomized cohort study of 100 consecutive unselected elderly patients with bilateral symptomatic knee arthritis with each knee randomized to receive either treatment protocol A consisting of conventional physical therapy or protocol B which is the same as protocol A with added low-level laser therapy. The mean follow-up was 6 years. Treatment failure was defined as breakthrough pain which necessitated joint replacement surgery. After a follow-up of 6 years, patients clearly benefited from treatment with protocol B as only one knee needed joint replacement surgery, while nine patients treated with protocol A needed surgery (p < 0.05). We conclude low-level laser therapy should be incorporated into standard conservative treatment protocol for symptomatic knee arthritis.


Knee pain Osteoarthritis Outcome Laser therapy 


Compliance with ethical standards

All elderly who entered the study were made known to the details of the study, signed consent, and agreed to come for periodic follow-up. All patients signed informed consent that they will be treated by low-level laser therapy machines approved by FDA, and that either Protocol A or B will be assigned at random.


No grants or supports from any company or institution were received for this study.


  1. 1.
    Hegedus B, Viharos L, Gervain M, Galfi M (2009) The effect of low-level laser in knee arthritis: a double-blind randomized placebo-controlled trial. Photomed Laser Surg 27(4):577–584CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Hashmi JT, Huang YY, Osmani BZ, Sharma SK, Naeser MA, Hamblin MR (2010) Role of low-level laser therapy in neuro-rehabilitation. Am Acad Phys Med Rehab 2(12 Suppl 2):S292–S305Google Scholar
  3. 3.
    Van Breugel HHFI, Bär PRD (1992) Power density and exposure time of He-Ne laser irradiation are more important than total energy dose in photo-biomodulation of human fibroblasts in vitro. Lasers Surg Med 12:528–537CrossRefPubMedGoogle Scholar
  4. 4.
    Lam TS, Abergel RP, Meeker CA, Castel JC, Dwyer RM, Uitto J (1986) Laser stimulation of collagen synthesis in human skin fibroblasts cultures. Lasers Life Sci 1:61–77Google Scholar
  5. 5.
    Brousseau L, Welch V, Wells G, Tugwell P, de Bie R, Gam A et al (2000) Low level laser therapy for osteoarthritis and rheumatoid arthritis: a meta-analysis. J Rheumatol 27(8):1961–1969Google Scholar
  6. 6.
    Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW (1988) Validation study of WOMAC: a health status instrument for measuring clinically important patient outcomes to anti-rheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol 15:1833–1840PubMedGoogle Scholar
  7. 7.
    Fransen M, McConnell S, Bell M (2003) Exercise for osteoarthritis of hip or knee. Cochrane Database Syst Rev 3, CD004286PubMedGoogle Scholar
  8. 8.
    Welch V, Brosseau L, Peterson J, Shea B, Tugwell P, Wells G (2001) Therapeutic ultrasound for osteoarthritis of the knee. Cochrane Database Syst Rev 2001(3):CD003132Google Scholar
  9. 9.
    Laufer Y, Dar G (2012) Effectiveness of thermal and athermal short-wave diathermy for the management of knee osteoarthritis: a systematic review and meta-analysis. Osteoarthr Cartil 20(9):957–966CrossRefPubMedGoogle Scholar
  10. 10.
    Osiri M, Welch V, Brosseau L, Shea B, Mcgowan J, Tugwell P et al (2007) Transcutaneous electrical nerve stimulation for knee osteoarthritis (Review). Cochrane Libr (4)Google Scholar
  11. 11.
    Rayegani SM, Bahrami MH, Elyaspour D, Saeidi M, Sanjari H (2012) Therapeutic effects of low-level laser therapy (LLLT) in knee osteoarthritis, compared to therapeutic ultrasound. J Lasers Med Sci 3(2)Google Scholar
  12. 12.
    Ip David (2007) Orthopedic rehabilitation, assessment and enablement. Springer-Verlag Heidelberg, Germany. Chapter 2Google Scholar
  13. 13.
    Baker KG, Robertson VJ, Duck FA (2001) A review of therapeutic ultrasound: biophysical effects. Phys Ther 811351–1358.1358Google Scholar
  14. 14.
    Ip D, Fu NY (2015) Can intractable discogenic back pain be managed by low-level laser therapy without recourse to operative intervention? J Pain Res 8:253–256CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Ip D, Fu NY (2015) Two year follow up of low-level laser therapy for painful adhesive capsulitis of the shoulder. J Pain Res 8:247–252CrossRefPubMedPubMedCentralGoogle Scholar
  16. 16.
    Huang Z, Chen J, Ma J, Shen B, Pei F, Kraus VB (2015) Effectiveness of low-level laser therapy in patients with knee osteoarthritis: a systematic review and meta-analysis. Osteoarthr Cartil 23(9):1437–1444CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag London 2015

Authors and Affiliations

  1. 1.Asia Medical Pain CentreMong KokHong Kong

Personalised recommendations