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Effects of photobiomodulation in the treatment of fractures: a systematic review and meta-analysis of randomized clinical trials

  • Frederico Carlos Jana Neto
  • Ana Luiza Cabrera MartimbiancoEmail author
  • Raíssa Piagentini de Andrade
  • Sandra Kalil Bussadori
  • Raquel Agnelli Mesquita-Ferrari
  • Kristianne Porta Santos Fernandes
Original Article
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Abstract

Several therapeutic strategies have been proposed to optimize the conventional treatment of fractures. Photobiomodulation (PBM) appears to help reduce pain and control inflammation, and it also accelerates bone repair. This systematic review aimed to evaluate the effectiveness and safety of PBM with low-level laser therapy (LLLT) in the bone fracture healing process. We included randomized controlled trials (RCTs) comparing the effects of PBM with those of any other intervention in adults with lower or upper limb bone fractures. The primary outcomes investigated were pain reduction, radiographic healing, and adverse events. The searches were conducted in October 2018. Two RCTs were included that compared PBM to the placebo. A meta-analysis showed significant difference in favor of PBM for pain reduction (MD 1.19, 95% CI [0.61 to 1.77], 106 participants, two RCTs), but this difference was not clinically significant. One RCT (50 participants) showed a clinical and statistical improvement in physical function (MD − 14.60, 95% CI [− 21.39 to − 7.81]) and no difference in radiographic healing, regarding absence of fracture line (RR 1.00, 95% CI [0.93 to 1.08]) and visible bone callus (RR 0.33, 95% CI [0.01 to 7.81]). The certainty of evidence was classified as low to very low. Based on the evidence of low to very low certainty, PBM seems to be associated with the improvement of pain and function. Therefore, new RCTs are required that meet the recommendations of CONSORT to prove the effectiveness and safety of this intervention and support its recommendation in clinical practice.

Keywords

Low-level light therapy Fracture healing Meta-analysis 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent is not applicable in this study.

Supplementary material

10103_2019_2779_MOESM1_ESM.pdf (389 kb)
ESM 1 (PDF 389 kb)

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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2019

Authors and Affiliations

  • Frederico Carlos Jana Neto
    • 1
  • Ana Luiza Cabrera Martimbianco
    • 2
    Email author
  • Raíssa Piagentini de Andrade
    • 3
  • Sandra Kalil Bussadori
    • 4
    • 5
  • Raquel Agnelli Mesquita-Ferrari
    • 4
    • 5
  • Kristianne Porta Santos Fernandes
    • 5
  1. 1.Universidade Nove de Julho (UNINOVE), Conjunto Hospitalar MandaquiSão PauloBrazil
  2. 2.Universidade Metropolitana de Santos (UNIMES)SantosBrazil
  3. 3.Universidade Nove de Julho (UNINOVE)São PauloBrazil
  4. 4.Postgraduate Program in Rehabilitation SciencesUniversidade Nove de Julho (UNINOVE)São PauloBrazil
  5. 5.Postgraduate Program in Biophotonics Applied to Health SciencesUniversidade Nove de Julho (UNINOVE)São PauloBrazil

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