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Photobiomodulation therapy (PBMT) on acute pain and inflammation in patients who underwent total hip arthroplasty—a randomized, triple-blind, placebo-controlled clinical trial

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Abstract

When conservative treatments fail, hip osteoarthritis (OA), a chronic degenerative disease characterized by cartilage wear, progressive joint deformity, and loss of function, can result in the need for a total hip arthroplasty (THA). Surgical procedures induced tissue trauma and incite an immune response. Photobiomodulation therapy (PBMt) using low-level laser therapy (LLLT) and/or light-emitting diode therapy (LEDT) has proven effective in tissue repair by modulating the inflammatory process and promoting pain relief. Therefore, the aim of this study was to analyze the immediate effect of PBMt on inflammation and pain of patients undergoing total hip arthroplasty. The study consisted of 18 post-surgical hip arthroplasty patients divided into two groups (n = 9 each) placebo and active PBMt who received one of the treatments in a period from 8 to 12 h following THA surgery. PBMt (active or placebo) was applied using a device consisting of nine diodes (one super-pulsed laser of 905 nm, four infrared LEDs of 875 nm, and four red LEDs 640 nm, 40.3 J per point) applied to 5 points along the incision. Visual analog scale (VAS) and blood samples for analysis of the levels of the cytokines TNF-α, IL-6, and IL-8 were recorded before and after PBMt application. The values for the visual analog scale as well as those in the analysis of TNF-α and IL-8 serum levels decreased in the active PBMt group compared to placebo-control group (p < 0.05). No decrease was observed for IL-6 levels. We conclude that PBMt is effective in decreasing pain intensity and post-surgery inflammation in patients receiving total hip arthroplasty.

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Funding

This study was supported by research grants 2010/52404-0 from São Paulo Research Foundation-FAPESP (Professor Ernesto Cesar Pinto Leal-Junior), 310281/2017-2 from Brazilian Council of Science and Technology Development-CNPq (Professor Ernesto Cesar Pinto Leal-Junior). FAPESP and CNPq had no role in the planning of this study; they had no influence on study design, data collection and analysis, decision to publish, or preparation of the article.

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Authors and Affiliations

  1. Laboratory of Phototherapy in Sports and Exercise, Universidade Nove de Julho (UNINOVE), Rua Vergueiro 235, São Paulo, SP, 01504-001, Brazil

    Luciana Gonçalves Langella, Heliodora Leão Casalechi & Ernesto Cesar Pinto Leal-Junior

  2. Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil

    Luciana Gonçalves Langella, Paulo de Tarso Camillo de Carvalho & Ernesto Cesar Pinto Leal-Junior

  3. Masters and Doctoral Programs in Physical Therapy, Universidade Cidade de São Paulo, São Paulo, SP, Brazil

    Shaiane Silva Tomazoni

  4. Multi Radiance Medical, Solon, OH, USA

    Douglas Scott Johnson

  5. Federal University of São Paulo (UNIFESP), São José dos Campos, SP, Brazil

    Regiane Albertini

  6. Postgraduate Program in Biophotonics Applied to Health Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil

    Rodney Capp Pallotta, Rodrigo Labat Marcos & Paulo de Tarso Camillo de Carvalho

Authors
  1. Luciana Gonçalves Langella
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  2. Heliodora Leão Casalechi
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  3. Shaiane Silva Tomazoni
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  4. Douglas Scott Johnson
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  5. Regiane Albertini
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  6. Rodney Capp Pallotta
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  7. Rodrigo Labat Marcos
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  8. Paulo de Tarso Camillo de Carvalho
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  9. Ernesto Cesar Pinto Leal-Junior
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Corresponding author

Correspondence to Ernesto Cesar Pinto Leal-Junior.

Ethics declarations

The present study was submitted and approved by the research ethics committee (process number 066490). All patients voluntarily agreed to participate and signed the informed consent statement.

Competing interests

Professor Ernesto Cesar Pinto Leal-Junior receives research support from Multi Radiance Medical (Solon, OH, USA), a phototherapy/photobiomodulation device manufacturer. Douglas Scott Johnson is an employee and a shareholder of Multi Radiance Medical (Solon-OH, USA). The remaining authors declare that they have no conflict of interests.

Ethical aspects

All experimental procedures were submitted and approved by the Research Ethics Committee of Nove de Julho University (process number 066490). All patients signed an informed consent form prior to enrollment.

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Langella, L.G., Casalechi, H.L., Tomazoni, S.S. et al. Photobiomodulation therapy (PBMT) on acute pain and inflammation in patients who underwent total hip arthroplasty—a randomized, triple-blind, placebo-controlled clinical trial. Lasers Med Sci 33, 1933–1940 (2018). https://doi.org/10.1007/s10103-018-2558-x

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