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

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.

High-Frequency Near-Infrared Diode Laser Irradiation Attenuates IL-1β-Induced Expression of Inflammatory Cytokines and Matrix Metalloproteinases in Human Primary Chondrocytes

“…Therefore, physical therapies such as ultrasound [24], electrical stimulation [25], exercise [26], spa therapy [27], and low-level laser therapy (LLLT) have been introduced. LLLT is listed as a nonpharmacological and noninvasive treatment option for OA [28], and intensive LLLT offers clinically relevant short-term pain relief for knee OA [29][30][31].…”

Management of otitis externa with an led-illuminated gel: a randomized controlled clinical trial in dogs

“…In this context, photobiomodulation (PBM) is widely known for its therapeutic benefits in the protection and regeneration of tissues [18][19][20][21][22][23]. Studies have demonstrated that PBM can reduce pain and inflammation [23][24][25], improve cancer management [26], and stimulate healing and tissue repair [20][21][22][27][28][29][30][31]. PBM is defined by the use of visible light to stimulate biological functions in a non-thermal and non-cytotoxic manner.…”

Low‐Intensity Photobiomodulation Decreases Neuropathic Pain in Paw Ischemia‐Reperfusion and Spared Nervus Ischiadicus Injury Experimental Models

“…The effect of infrared radiation on nerves has been shown in the literature in relation to the photobiological mechanisms of infrared LED, which has an anti‐inflammatory action, such as the modulation of cyclooxygenases and lipoxygenases and the reduction of inflammatory mediators such as prostaglandins, prostacyclins, bradykinin, histamine, substance P, interleukin 1 beta, and tumor necrosis factor alpha, decreasing the activation of the nociceptors . In addition, many studies have shown satisfactory results in relation to the effects of infrared, near‐infrared, or both wavelengths on different pathological conditions such as burn wounds, postsurgery pain, Achilles tendinopathy, hip arthroplasty, knee osteoarthritis, and oral mucositis, where there is an inflammatory process. It is very important to understand whether the chromophores activated by different wavelengths are correlated with the individual responses or eventual cumulative response of both wavelengths in the same treatment.…”