From concept to practice: intra-articular photobiomodulation for knee osteoarthritis

作者：Hao Chen, Feifei Gao, Yu Luo, Rui Wang, Arum Dwijayanti Niken, Zhe Xu, Yi Ding, Yi Guo · 发表于：Frontiers in Immunology · 年份：2026 · DOI：10.3389/fimmu.2026.1793440 · 被引用次数：1 · 研究领域：Laser Applications in Dentistry and Medicine、Photodynamic Therapy Research Studies、Oral health in cancer treatment

Knee osteoarthritis (KOA) is a prevalent degenerative joint disease worldwide. Current treatments primarily offer only symptomatic relief and lack disease-modifying efficacy. Photobiomodulation therapy (PBMT) has shown potential in modulating cellular metabolism and inflammation to alleviate KOA symptoms; however, its conventional transcutaneous delivery is significantly limited by inadequate tissue penetration and energy attenuation, leading to inconsistent clinical outcomes. To overcome these limitations, this review proposes an innovative therapeutic paradigm: intra-articular PBM. This approach involves the minimally invasive placement of miniaturized light sources—such as fibre-integrated acupuncture needles or micro-LEDs—directly into the joint cavity, enabling precise, in situ energy delivery to pathological tissues. Light in the 600–1000 nm range is absorbed by mitochondrial cytochrome c oxidase, initiating a cascade of biological effects including: activation of the Nrf2 pathway to enhance antioxidant capacity; suppression of the NF-κB pathway to reduce inflammation; promotion of analgesia via peripheral and central mechanisms; induction of autophagy; and inhibition of apoptosis. Together, these mechanisms contribute to chondroprotection and improvement of subchondral bone structure. Both short-term interventional and long-term implantable strategies are discussed, with emerging preclinical and early clinical evidence supporting the feasibility and efficacy of this ta...