title: Laser-needle therapy for spontaneous osteonecrosis of the knee.
abstract: OBJECTIVE
  This case report describes the treatment of a 63-year-old patient with spontaneous osteonecrosis of the knee (SONK).
  
  
  BACKGROUND
  SONK usually appears in the elderly patient without the typical risk factors for osteonecrosis. It is characterized by acute and sudden pain, mostly occurring at the medial side of the knee joint. Symptoms usually worsen with physical activity and improve with rest. Besides physical therapy, limited weight-bearing and the use of analgesics and nonsteroidal anti-inflammatory drugs, we propose low-level laser therapy (LLLT) as a conservative treatment option.
  
  
  METHODS
  LLLT was carried out using laser needles emitting radiation with wavelengths of 685 and 885 nm, and a power density of 17.8 W/cm(2). Therapy sessions lasted 60 min and were performed daily over a period of 3 mo. The total irradiation dose emitted by 8 laser needles in 60 min of treatment was 1008 J.
  
  
  RESULTS
  Magnetic resonance imaging revealed distinct restitution of the spongiosa edema 5 wk after treatment onset, and the final check-up at 35 wk demonstrated complete restoration of integrity.
  
  
  CONCLUSIONS
  The present case report provides the first indication that laser-needle therapy may be a promising tool for complementary and alternative therapeutic intervention for those with SONK.
authors.affiliation: Department of Sports Medicine, Goethe-University Frankfurt/Main, University of Paderborn, Frankfurt/Main, Germany. banzer@sport.uni-frankfurt.de
authors.forename: Winfried
authors.initials: W
authors.lastname: Banzer
authors.forename: Markus
authors.initials: M
authors.lastname: Hübscher
authors.forename: Detlef
authors.initials: D
authors.lastname: Schikora
mesh_terms: D006801:Humans; D007719:Knee Joint / Q000528:radiation effects*; D028022:Low-Level Light Therapy / Q000295:instrumentation*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009339:Needles; D010020:Osteonecrosis / Q000175:diagnosis / Q000532:radiotherapy*