Background: Knee osteoarthritis (KOA) is a common degenerative joint disorder that affects 250 million people globally. The most common treatment for KOA is non-steroidal anti-inflammatory drug administration. However, the analgesic effect is limited and often accompanied by multiple side effects. Hence, many KOA patients opt for complementary and alternative medicine. Acupuncture is one of the most popular complementary treatments with great analgesic effect and minimal side effect. Laser acupuncture is a photonic stimulation of acupoints and areas, initiating therapeutic effects similar to that of needle acupuncture and related therapies together with photobiomodulation. Acupoints focused ultrasound is the application of an ultrasound stimulus to the acupuncture meridian system

Objective: To investigate the difference between the effects of laser acupuncture versus acupoint focused ultrasound on knee osteoarthritis.

Subject and Methods: 51 Subjects of both genders with age range from (45-65) years old with grade 2 and 3 knee osteoarthritis was participate in this study and was conducted at outpatient physical clinics in Cairo University.

Three groups with 17 patients for each group, (group A) received laser acupuncture in addition traditional exercises for 3 sessions per week for four weeks, (group B) received acupoint focused ultrasound in addition to traditional exercise for 3 sessions per week for four weeks and (group C) received only traditional exercise for 3 sessions per week for four weeks. All patients were evaluated before and after the treatment using visual analogue scale, digital goniometer, Western Ontario and McMaster Universities osteoarthritis index (WOMAC).

Results: There was a significant decrease in VAS of group A compared with that of group B (p = 0.001) and group C (p = 0.001), There was a significant decrease in pain, stiffness and function scores of group A compared with that of group B (p < 0.01) and group C (p < 0.001), There was a significant increase in flexion ROM of group A compared with that of group B and group C (p < 0.001) and There was a significant increase in extension ROM of group A compared with that of group B (p = 0.02) and group C (p = 0.02).