The use of PBM can be divided into two clinical scenarios
A. Conservative Treatment and Acute Phase (Post-Trauma) PBM will be used to control immediate symptoms and prepare the tissue for healing (in the case of stable partial injury) or surgery (emergency surgery is generally only performed on high-level athletes).
Anti-inflammatory action: By modulating the production of pro-inflammatory cytokines (e.g., IL-1, IL-6, and TNF-α) and increasing anti-inflammatory factors, PBM reduces oedema. 3
Analgesic action: It acts directly on nocioceptors (nerve conduction) and reduces the production of pain mediators, contributing to non-pharmacological pain management. 4
B. Post-operative (ligamentoplasty) The main interest for surgeons and physical therapists is the potential impact on graft healing and early rehabilitation.
PBM optimizes graft take up: It stimulates fibroblast proliferation and type I collagen synthesis (the main collagen component of the ACL and the graft). This accelerates the critical phase of revascularization and remodeling of the graft . 5
Action on post-operative pain: Facilitating better pain management accelerates recovery of range of motion (ROM). 35
Main objective
Clinical Phase
Recommended Dosage (Indicative)
Frequency/ Duration
Area of Application
Analgesic & Anti-oedema
Acute Phase (Immediate Post- Traumatic or Early Post-Operative Days 1 to 7)
Low/Moderate Fluence (energy density) (2 to 6 J/cm 2 )
Daily
Along the edges of the incision and around the effusion /oedema.
Graft Optimization & Healing 5
Early/Middle Phase (from D7/21)
Moderate Fluence of 6-10 J/cm 2
3 times/week.
On the reconstructed tendon/ligament (healing), graft harvest site. Knee flexed at 90°
9
Made with FlippingBook - PDF hosting