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

Seyed Mansour Rayegani--- Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,
Seyed Ahmad Raeissadat--- Physical Medicine and Rehabilitation Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,
Saeed Heidari--- Health Technology Assessment, Social Development & Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran,
Mohammad Moradi-Joo--- Health Technology Assessment, Iran Health Insurance Organization, Tehran, Iran

Abstract


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Low Level Laser Therapy 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. 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 extracted by two reviewers. Standard mean difference proposed through Inverse Variance was used in the meta-analysis using the random-effects model. Twelve values were used for the evaluation of heterogeneity. A total of 823 studies, 14 RCTs were selected after final review. There was a significant difference between LLLT and Placebo in pain at rest (p=0.02), pain at activity (p=0.01), total pain (p=0.03), WOMAC function (p=0.01), WOMAC stiffness (p=0.02) and WOMAC total (p<0.0001) in favor of the LLLT. There was no significant difference between LLLT and Placebo in WOMAC pain (p=0.09) and range of motion (p=0.1). In spite of some positive findings, this meta-analysis lacked data on how LLLT effectiveness is affected with important factors: wavelength, energy density, treatment duration, numbers of sessions the treatment, severity of KOA and site of application.


Keywords


Knee, Osteoarthritis; Low level laser therapy; Effectiveness; Meta-analysis

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