Efficacy of Pulsed Nd:YAG Laser in the Treatment of Patients with Knee Osteoarthritis: a Randomized Controlled Trial

Overview

Journal Lasers Med Sci

Publisher Springer

Date 2017 Jan 13

PMID 28078503

Citations 27

Authors

Mohamed Salaheldien Mohamed Alayat

Tarek Helmy Ahmed Aly

Aly Elsayed Mohamed Elsayed

Ammar Suliman Mohamed Fadil

Affiliations

Soon will be listed here.

Abstract

The purpose of this study was to investigate the effects of pulsed Nd:YAG laser plus glucosamine/chondroitin sulfate (GCS) in patients with knee osteoarthritis (KOA) by examining changes in pain and knee function, as well as synovial thickness (ST) and femoral cartilage thickness (FCT). Sixty-seven male patients participated, with a mean (SD) age of 53.85 (4.39) years, weight of 84.01 (4.70) kg, height of 171.51 (3.96) cm, and BMI of 28.56 (1.22). Group 1 was treated with high-intensity laser therapy (HILT), GCS, and exercises (HILT + GCS + EX). Group 2 was treated with GCS plus exercises (GCS + EX), and group 3 received placebo laser plus exercises (PL + EX). The outcomes measured were pain level and functional disability using the visual analog scale (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), respectively. ST and FCT were measured by ultrasound examination. Statistical analyses were performed to compare differences between baseline and after 6 weeks of treatment and then after 3 months of follow-up. Statistical significance was set at p < 0.05. VAS and WOMAC were significantly decreased in all groups after 6 weeks, with nonsignificant differences between 6 weeks and 3 months of follow-up. ST was significantly decreased in the HILT + GCS + EX group posttreatment, with nonsignificant decreases in the GCS + EX and PL + EX groups, as well as nonsignificant differences to FCT in all groups. Overall, pulsed Nd:YAG laser combined with GCS and exercises was more effective than GCS + EX and exercises alone in the treatment of KOA patients.

Citing Articles

Comparison of the Effect of High-Intensity Laser Therapy and Quadriceps Muscle Strengthening Exercises Using Biofeedback on Pain, Stiffness and Function of Patients with Knee Osteoarthritis: A Randomized Clinical Trial.

Rahimi M, Jafari-Nozad A, Jazebi F Anesth Pain Med. 2025; 14(6):e143642.

PMID: 40078642 PMC: 11895785. DOI: 10.5812/aapm-143642.

Efficacy of high intensity laser therapy versus sham laser in symptomatic knee osteoarthritis: a double-blind randomized controlled trial.

Laotammateep C, Champaiboon J, Surarangsit T, Likhitphithak W, Boonhong J Lasers Med Sci. 2025; 40(1):87.

PMID: 39945920 DOI: 10.1007/s10103-025-04352-8.

The effect of high-intensity versus photobiomodulation therapy (PBM) on the regeneration of the sciatic nerve following crush injury: an animal study.

Bayburt K, Diker N, Aydin M, Dolanmaz D Lasers Med Sci. 2025; 40(1):81.

PMID: 39921755 PMC: 11807069. DOI: 10.1007/s10103-025-04334-w.

High-Intensity Laser Therapy in Pain Management of Knee Osteoarthritis.

Poenaru D, Sandulescu M, Potcovaru C, Cinteza D Biomedicines. 2024; 12(8).

PMID: 39200144 PMC: 11351435. DOI: 10.3390/biomedicines12081679.

Efficacy of High-Intensity and Low-Level Laser Therapy Combined With Exercise Therapy on Pain and Function in Knee Osteoarthritis: A Systematic Review and Network Meta-analysis.

Khalilizad M, Hosseinzade D, Marzban Abbas Abadi M J Lasers Med Sci. 2024; 15:e34.

PMID: 39193110 PMC: 11348445. DOI: 10.34172/jlms.2024.34.

References

Bellamy N, BUCHANAN W, Goldsmith C, Campbell J, Stitt L . Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988; 15(12):1833-40. View

Yildiriim M, Ucar D, Ones K . Comparison of therapeutic duration of therapeutic ultrasound in patients with knee osteoarthritis. J Phys Ther Sci. 2016; 27(12):3667-70. PMC: 4713767. DOI: 10.1589/jpts.27.3667. View

Samoilova K, Zhevago N, Petrishchev N, Zimin A . Role of nitric oxide in the visible light-induced rapid increase of human skin microcirculation at the local and systemic levels: II. healthy volunteers. Photomed Laser Surg. 2008; 26(5):443-9. DOI: 10.1089/pho.2007.2205. View

Creamer P, Lethbridge-Cejku M, Hochberg M . Factors associated with functional impairment in symptomatic knee osteoarthritis. Rheumatology (Oxford). 2000; 39(5):490-6. DOI: 10.1093/rheumatology/39.5.490. View

Felson D, Lawrence R, Dieppe P, Hirsch R, Helmick C, Jordan J . Osteoarthritis: new insights. Part 1: the disease and its risk factors. Ann Intern Med. 2000; 133(8):635-46. DOI: 10.7326/0003-4819-133-8-200010170-00016. View

Colombo F, Neto A, de Sousa A, Marchionni A, Pinheiro A, de Almeida Reis S . Effect of low-level laser therapy (λ660 nm) on angiogenesis in wound healing: a immunohistochemical study in a rodent model. Braz Dent J. 2013; 24(4):308-12. DOI: 10.1590/0103-6440201301867. View

Kheshie A, Alayat M, Ali M . High-intensity versus low-level laser therapy in the treatment of patients with knee osteoarthritis: a randomized controlled trial. Lasers Med Sci. 2014; 29(4):1371-6. DOI: 10.1007/s10103-014-1529-0. View

Tascioglu F, Armagan O, Tabak Y, Corapci I, Oner C . Low power laser treatment in patients with knee osteoarthritis. Swiss Med Wkly. 2004; 134(17-18):254-8. DOI: 10.4414/smw.2004.10518. View

Jamtvedt G, Dahm K, Holm I, Odegaard-Jensen J, Flottorp S . Choice of treatment modalities was not influenced by pain, severity or co-morbidity in patients with knee osteoarthritis. Physiother Res Int. 2009; 15(1):16-23. DOI: 10.1002/pri.452. View

10.

da Rosa A, Ferreira Dos Santos A, da Silva M, Facco G, Perreira D, Alves A . Effects of low-level laser therapy at wavelengths of 660 and 808 nm in experimental model of osteoarthritis. Photochem Photobiol. 2011; 88(1):161-6. DOI: 10.1111/j.1751-1097.2011.01032.x. View

11.

Bayat M, Ansari E, Gholami N, Bayat A . Effect of low-level helium-neon laser therapy on histological and ultrastructural features of immobilized rabbit articular cartilage. J Photochem Photobiol B. 2007; 87(2):81-7. DOI: 10.1016/j.jphotobiol.2007.02.002. View

12.

Kumm J, Tamm A, Lintrop M, Tamm A . Association between ultrasonographic findings and bone/cartilage biomarkers in patients with early-stage knee osteoarthritis. Calcif Tissue Int. 2009; 85(6):514-22. DOI: 10.1007/s00223-009-9302-2. View

13.

Hagiwara S, Iwasaka H, Hasegawa A, Noguchi T . Pre-Irradiation of blood by gallium aluminum arsenide (830 nm) low-level laser enhances peripheral endogenous opioid analgesia in rats. Anesth Analg. 2008; 107(3):1058-63. DOI: 10.1213/ane.0b013e31817ee43e. View

14.

Jang H, Lee H . Meta-analysis of pain relief effects by laser irradiation on joint areas. Photomed Laser Surg. 2012; 30(8):405-17. PMC: 3412059. DOI: 10.1089/pho.2012.3240. View

15.

Kahan A, Uebelhart D, De Vathaire F, Delmas P, Reginster J . Long-term effects of chondroitins 4 and 6 sulfate on knee osteoarthritis: the study on osteoarthritis progression prevention, a two-year, randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2009; 60(2):524-33. DOI: 10.1002/art.24255. View

16.

de Oliveira Melo M, Pompeo K, Baroni B, Vaz M . Effects of neuromuscular electrical stimulation and low-level laser therapy on neuromuscular parameters and health status in elderly women with knee osteoarthritis: A randomized trial. J Rehabil Med. 2016; 48(3):293-9. DOI: 10.2340/16501977-2062. View

17.

Sawitzke A, Shi H, Finco M, Dunlop D, Harris C, Singer N . Clinical efficacy and safety of glucosamine, chondroitin sulphate, their combination, celecoxib or placebo taken to treat osteoarthritis of the knee: 2-year results from GAIT. Ann Rheum Dis. 2010; 69(8):1459-64. PMC: 3086604. DOI: 10.1136/ard.2009.120469. View

18.

Moriyama Y, Nguyen J, Akens M, Moriyama E, Lilge L . In vivo effects of low level laser therapy on inducible nitric oxide synthase. Lasers Surg Med. 2009; 41(3):227-31. DOI: 10.1002/lsm.20745. View

19.

Sakurai Y, Yamaguchi M, Abiko Y . Inhibitory effect of low-level laser irradiation on LPS-stimulated prostaglandin E2 production and cyclooxygenase-2 in human gingival fibroblasts. Eur J Oral Sci. 2000; 108(1):29-34. DOI: 10.1034/j.1600-0722.2000.00783.x. View

20.

Cowan S, Bennell K, Hodges P, Crossley K, McConnell J . Delayed onset of electromyographic activity of vastus medialis obliquus relative to vastus lateralis in subjects with patellofemoral pain syndrome. Arch Phys Med Rehabil. 2001; 82(2):183-9. DOI: 10.1053/apmr.2001.19022. View