Safety and Effectiveness of Low-Level Laser Therapy in Patients With Knee Osteoarthritis: A Systematic Review and Meta-analysis

Abstract

Please cite this article as follows: Rayegani SM, Raeissadat SA, Heidari S, Moradi-Joo M. Safety and effectiveness of low-level laser therapy in patients with knee osteoarthritis: a systematic review and meta-analysis. J Lasers Med Sci. 2017;8(Suppl 1):S12-S19. doi:10.15171/ jlms.2017.s3. IntroductionOsteoarthritis is one of the most common diseases which has affected many people; this disease increases with age. In general, it may be said that approximately 14% of adults in United States and 40% of the population under 65 years old in Britain and Australia suffer from this disease; this disease prevalence is growing.1 Osteoarthritis is an example of physical and motor disability and one of the most important causes of functional disabilities in individuals, and imposes significant costs to individuals and consequently, to society. 2Knee osteoarthritis (KOA) is one of the most common osteoarthritis types and is associated with symptoms such as knee stiffness, pain, and limited movement range of knee joint. These conditions lead to physical function impairment, limited independence in doing daily life activities, decreased quality of life, and other disabilities. 3,4 KOA is also known as arthritis or knee joint stiffness; it mainly affects the articular cartilage. The articular cartilage is a soft tissue which is inside the joint and between bones; in the case of its damage, the bones will rub on each other and extended bone will be created around the joint. Ultimately, the ligaments and muscles around the joint will be narrowed and weakened. [1][2][3][4] There are several different treatments to control this disease (pharmacotherapy, surgery, physiotherapy, exercise therapy). It seems that the use of these methods depends on disease stage and patient's specific condition. In general, however, the logic and philosophy of these methods is relieving patient from pain, make him/her independent in doing daily life activities, and improving his/her life. 5Due to numerous complications which are associated with using non-steroidal drugs, using them to control this disease is limited. 5 Recently, other therapies which are based on rehabilitation methods (such as exercise therapy, tensile muscle movement, electrical stimulation, acupuncture, and heat therapy) are more considered by physicians than using non-steroidal drugs.6 Low-level laser therapy (LLLT) is one of the safe and non-invasive methods which has recently attracted the attention of Iran Health Insurance Organization, Tehran, Iran Abstract Introduction: Low-level laser therapy (LLLT) was introduced as an alternative non-invasive treatment for osteoarthritis, but its effectiveness is still controversial. The main objective of this article was to determine the safety and efficacy of LLLT in patients with knee osteoarthritis (KOA). Methods:In order to gather evidence, main medical databases as well as relevant websites were browsed without time limit. We searched with appropriate keywords and strategies. After quality assessment of studies, study data were extrac...

Effects of Low-Level Laser Versus Laser Acupuncture in Patients With Knee Osteoarthritis: A Randomized Controlled Trial

“…Similarly, there was no evidence of LLLT effectiveness based on Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain, stiffness or function outcomes (5 and 3 studies had outcome data right after therapy and 12 weeks after therapy, respectively). But Rayegani and colleagues [23] analysis reports a significant pain reduction in patients who received the LLLT. The efficacy of the LLLT in the KOA patients has remained unknown due to these conflicting results.…”

“…mitochondrial cytochromes) is presumed to trigger the photobiomodulation effects such as analgesia, anti-inflammation, and increase in protein and collagen synthesis, which enhance cellular metabolism and promote function and soft-tissue healing [22]. The effect of the LLLT on the KOA is related to the number of affected points, laser wavelength, energy density, continuous or pulse mode application, treatment duration, the method of application, number of sessions, follow-up, the severity of the OA, and surface of application [23].…”

Exercise program combined with electrophysical modalities in subjects with knee osteoarthritis: a randomised, placebo-controlled clinical trial

“…Photobiomodulation is another resource that, despite the heterogeneity of available scientific evidence on the effectiveness of its application in knee OA, is routinely used to relieve pain and improve function [44,45]. This heterogeneity is often attributed to the variation in doses used by different studies [46].…”

“…Among these, physical agents are widely used, including electrical, electromagnetic and phototherapeutic treatments [13]. With an emphasis on transcutaneous electrical nerve stimulation, interferential current therapy (ICT) [14,15], shortwave diathermy therapy (SDT) [16] and photobiomodulation (PHOTO) [17] have been shown to improve pain and function, as well as increase the strength of the knee extensors [14][15][16][17].…”

Medical rehabilitation in the combination treatment of rheumatic diseases: a review

“…Однако в недавно опубликованной работе S. Rayegani и соавт. [28], представляющей собой метаанализ 14 РКИ, были показаны более оптимистичные данные. Так, НИЛИ демонстрировало преимущество в сравнении с ПЛ по уменьшению боли в покое (р=0,02) и при движении (p=0,01), динамике WOMAC функции (р=0,01), WOMAC скованности (р=0,02) и общего индекса WOMAC (р<0,0001).…”