Can Laser Therapy be
used to Treat Meniscal Injuries?

Low-Level Laser Therapy in
Meniscal Pathology: a Double-Blinded Placebo-Controlled Trial

Malliaropoulos N, Kiritsi O,
Tsitas K, Christodoulou D, Akritidou A, Del Bueno A, &
Maffulli N. Lasers in Medicine and Science. Epub ahead of print
October 24, 2012. DOI:10.1007/s10103-012-1219-8

meniscal injury is the most common cause of symptomatic knee pain.  Due to the inability of the meniscus to heal,
current management of these injuries involves symptomatic management, and
surgery as needed. Low-level laser therapy (LLLT) for soft tissue injuries has
become increasingly apparent in recent years, with claims of reduction in pain,
inflammation, as well as accelerated healing time.  It is currently being used for these possible
benefits; however, its effectiveness for treating meniscal tears is still
unknown.  Therefore, the purpose of this
double-blind placebo-controlled study was to assess the effectiveness of LLLT
in 64 patients with symptomatic medial meniscus injuries.  Half of the patients were randomized to
receive LLLT and the other half was randomized to receive sham treatment.  The results were compared between the two
groups using a visual analog scale (VAS) for knee pain, Lysholm Knee Scoring
System (knee pain and function), and swelling of the knee.  The LLLT group demonstrated significant
improvements from baseline at all time points (i.e., 4 weeks, 6 months, 1 year
post treatment).  Furthermore, at 4 weeks
post treatment, the VAS and Lysholm scores were significantly improved in the
LLLT when compared to the sham group.

demonstrated effectiveness in a population with symptomatic meniscal
pathology.  It still remains unclear as
to mechanistically why LLLT may have had superior outcomes.  Some theories include an analgesic effect of
LLLT which could have been caused by improved healing and decreased
pain-receptor stimulation.  Depth of
penetration of any laser therapy is limited (~ 5mm) due to superficial tissues
absorbing the energy.  It would have been
interesting if this study had taken a follow-up MRI to determine if there had
been any structural changes that occurred within the involved knees.  This would appropriately address whether or
not healing is actually occurring, or if the LLLT slows ensuing degenerative
changes that may be occurring in the sham group.  Also, if LLLT has the ability to decrease
inflammation, this would be reinforced if the authors of the study assessed
biochemical markers of the involved joint. 
The findings of this study are certainly exciting as to the future
possibilities, but there still remains much to be answered.  The authors looked at a very specific set of
inclusion criteria for meniscal injury; I wonder what the applicability may be
across other types of meniscal or even other knee pathologies.  I also wonder if these patients went on to
have surgery or if this prevented the need for surgical intervention.  And lastly, what are the long-term effects of
this on degenerative changes of the knee. 
Clinically, I am not sure how many athletic training programs have
lasers.  Does anyone have any experiences
using one?  What kind of outcomes have
people seen?

by: Nicole Cattano 
by: Stephen Thomas


Malliaropoulos N, Kiritsi O, Tsitas K, Christodoulou D, Akritidou A, Del Buono A, & Maffulli N (2012). Low-level laser therapy in meniscal pathology: a double-blinded placebo-controlled trial. Lasers in Medical Science PMID: 23093133