LightNeedle - RJ Laser

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[11] Litscher G., Computer-based objectivation of traditional Chinese-, ear- and Korean hand acupuncture, Needle-induced changes of regional cerebral blood flow velocity. Neurol. Res. 24 (2002), 377-380. [12] G. Litscher and D. Schikora, Effects of new noninvasive laserneedles on brain function. EMBEC 2002. 2 nd European Medical & Biological Engineering Conference, Vienna, December 2002, in press. [13] G. Litscher, L. Wang and M. Wiesner-Zechmeister, Specific effects of laserpuncture on the cerebral circulation, Lasers Med. Sci. 15 (2000), 57-62. [14] G. Litscher, G. Schwarz, L. Wang and A. Sandner-Kiesling, Akupunktur bei vaskulär bedingtem dementiellem Abbau. Jahrestagung der Österreichischen Alzheimer-Gesellschaft. 14. Klagenfurter Arbeitstagung für Neurologie. 24. - 25. Mai 2002, Klagenfurt / Austria. 15
Photomedicine and Laser Surgery Volume 26, Number 4, 2008 © Mary Ann Liebert, Inc. Pp. 301–306 DOI: 10.1089/pho.2007.2188 Abstract Laser-Needle Therapy for Spontaneous Osteonecrosis of the Knee Winfried Banzer, M.D., Ph.D., 1 Markus Hübscher, Ph.D., 1 and Detlef Schikora, Ph.D. 2 Objective: This case report describes the treatment of a 63-year-old patient with spontaneous osteonecrosis of the knee (SONK). Background Data: 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 lowlevel 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. Conclusion: 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. Introduction STEONECROSIS OF THE KNEE was first described by Ahlbäck Oand colleagues in 1968, and has been classified into two distinct types: (1) spontaneous or idiopathic osteonecrosis, and (2) secondary osteonecrosis associated with various risk factors such as steroid therapy, renal transplantation, systemic lupus erythematosus (SLE), alcohol abuse, caisson decompression sickness, Gaucher’s disease, and hemoglobinopathies. 1,2 Spontaneous osteonecrosis of the knee (SONK) usually appears in the elderly patient over 55 years of age without the typical risk factors for osteonecrosis, with an age-related prevalence between 3.4% and 9.4%. 3 Women are three times more often affected than men. SONK 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. Also, nocturnal pain is frequently observed, and clinical examination shows local hypersensitivity to pressure. 4 Even though the precise etiology still remains unclear, two major theories have been proposed. 5 The traumatic theory suggests that repeated microtraumata in porotic bone cause stress fractures and 301 successive necrosis. 6 According to the vascular theory, occlusion of the blood supply at the arterial and venous side may lead to decreased bone microcirculation with subsequent edema formation. Edema increases bone marrow pressure, further diminishing the blood supply and resulting in osseus ischemia and necrosis. 4 Furthermore, elevated bone marrow pressure due to increased fat cell size and fat microemboli has been suggested to impair intraosseus microcirculation. 7 Established treatment options comprise physical therapy, limited weight-bearing, and the use of analgesics and nonsteroidal anti-inflammatory drugs. These conservative approaches are recommended, usually in the early stages of disease. But even in such cases, progression can not always be successfully hindered, and patients with severe necrotic changes may require surgical intervention (e.g., high tibial osteotomy or total knee replacement). 2,8–10 In this context and in consideration of the basic research on the biostimulatory effects of low-level laser therapy (LLLT) on microcirculation and vascularization as well as on osteogenesis, and its clinical effectiveness in bone and joint diseases such as osteoarthritis and rheumatoid arthritis, we propose LLLT as a promising therapeutic option for patients with 1 Department of Sports Medicine, Goethe-University Frankfurt/Main, and 2 Department of Physics and Optoelectronic, University of Paderborn, Germany.
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