HIGH-INTENSITY LASER THERAPY IN KNEE REHABILITATION: A LITERATURE REVIEW WITH IMPLICATIONS FOR RECOVERY AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION
Keywords:
high-intensity laser therapy, anterior cruciate ligament reconstruction, knee rehabilitation, literature reviewAbstract
High-intensity laser therapy (HILT) is increasingly used as an adjunct in the rehabilitation of musculoskeletal disorders and knee conditions because of its analgesic, anti-inflammatory and biostimulative effects. The objective of this literature review was to analyze randomized clinical studies published from 2020 to 2025 on the effects of HILT, or a comparable high-intensity electrophysical modality, on pain, muscle strength, range of motion and knee function, with particular interest in rehabilitation following anterior cruciate ligament (ACL) reconstruction. PubMed, Medline and ScienceDirect were searched using terms related to HILT, high-power laser therapy, class IV laser therapy, ACL reconstruction and postoperative knee rehabilitation. Randomized controlled or comparative clinical studies involving adults were considered when sufficient methodological and outcome data were available. No randomized clinical study investigating HILT specifically after ACL reconstruction was identified within the defined period. The eligibility criteria were therefore extended to related knee conditions and high-intensity physical modalities. Ten publications based on studies conducted in Poland, Malaysia, Turkey and North Macedonia were analyzed. Most studies involved patients with knee osteoarthritis, while individual studies examined patellofemoral pain syndrome, lateral epicondylitis and the application of High Tone Power Therapy after ACL reconstruction. The most frequently assessed outcomes were pain intensity, functional status, knee flexion, muscle strength and articular cartilage thickness. Comparative studies generally demonstrated greater improvements in pain, function and mobility following HILT than following low-intensity laser therapy or other electrophysical modalities. Findings concerning High Tone Power Therapy indicate possible benefits for quadriceps strength recovery and reduction of joint effusion after ACL reconstruction; however, this modality cannot be considered direct evidence of the effectiveness of HILT. Interpretation of the overall findings was limited by differences in laser dosage, treatment schedules, outcome instruments, follow-up periods, sample sizes and rehabilitation programs provided to the control groups. Current evidence supports HILT as a potentially useful adjunct in the rehabilitation of selected knee disorders, but remains insufficient to support a firm recommendation for its use during early rehabilitation after ACL reconstruction. The identified research gap justifies future adequately powered randomized trials using standardized laser parameters, clearly defined rehabilitation protocols and outcome measures relevant to postoperative recovery
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