{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T20:35:55Z","timestamp":1784234155359,"version":"3.55.0"},"reference-count":67,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T00:00:00Z","timestamp":1774224000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>\n                    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\u2014such as fibre-integrated acupuncture needles or micro-LEDs\u2014directly into the joint cavity, enabling precise,\n                    <jats:italic>in situ<\/jats:italic>\n                    energy delivery to pathological tissues. Light in the 600\u20131000 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-\u03baB 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 targeted approach. Intra-articular PBM represents a significant shift from palliative symptom management to targeted, mechanism-based tissue repair. Although challenges remain in device durability, biocompatibility, and clinical translation pathways, this strategy holds considerable promise as a potential disease-modifying therapy for KOA and may offer a novel, minimally invasive treatment option for patients in the future.\n                  <\/jats:p>","DOI":"10.3389\/fimmu.2026.1793440","type":"journal-article","created":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T05:21:24Z","timestamp":1774243284000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["From concept to practice: intra-articular photobiomodulation for knee osteoarthritis"],"prefix":"10.3389","volume":"17","author":[{"given":"Hao","family":"Chen","sequence":"first","affiliation":[{"name":"Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine","place":["Tianjin, China"]},{"name":"School of Acupuncture & Moxibustion and Tuina, Tianjin 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