Can combined use of low-level lasers and hyaluronic acid injections prolong the longevity of degenerative knee joints?
BACKGROUND
This study evaluated whether half-yearly hyaluronic acid injection together with low-level laser therapy in addition to standard conventional physical therapy can successfully postpone the need for joint replacement surgery in elderly patients with bilateral symptomatic tricompartmental knee arthritis.


METHODS
In this prospective, double-blind, placebo-controlled study, 70 consecutive unselected elderly patients with bilateral tricompartmental knee arthritis were assigned at random to either one of two conservative treatment protocols to either one of the painful knees. Protocol A consisted of conventional physical therapy plus a sham light source plus saline injection, and protocol B consisted of protocol A with addition of half-yearly hyaluronic acid injection as well as low-level laser treatment instead of using saline and a sham light source. Treatment failure was defined as breakthrough pain necessitating joint replacement.


RESULTS
Among the 140 painful knees treated with either protocol A or protocol B, only one of the 70 painful knees treated by protocol B required joint replacement, whereas 15 of the 70 painful knees treated by protocol A needed joint replacement surgery (P<0.05).


CONCLUSIONS
We conclude that half-yearly hyaluronic acid injections together with low-level laser therapy should be incorporated into the standard conservative treatment protocol for symptomatic knee arthritis, because it may prolong the longevity of the knee joint without the need for joint replacement.
Asia Medical Pain Centre, Grand Plaza, Mong Kok, Hong Kong.
David
D
Ip
Asia Medical Pain Centre, Grand Plaza, Mong Kok, Hong Kong.
Nga Yue
NY
Fu
D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D007270:Injections, Intra-Articular; D028022:Low-Level Light Therapy / Q000379:methods*; D008297:Male; D020370:Osteoarthritis, Knee / Q000628:therapy*; D011446:Prospective Studies; D012720:Severity of Illness Index; D055675:Viscosupplements / Q000008:administration & dosage / Q000627:therapeutic use*
D055675:Viscosupplements; D006820:Hyaluronic Acid
hyaluronic acid injection; knee osteoarthritis; low-level laser; outcome