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During transcutaneous irradiation, light energy undergoes significant scattering and attenuation as it traverses multiple tissue layersincluding skin, subcutaneous fat, and the joint capsuleresulting in effective energy densities reaching deep pathological areas (such as cartilage and synovium) that may fall far below the threshold required to induce biological stimulation effects ( Against this backdrop, intra-articular PBM has emerged as a novel paradigm designed to overcome the limitations of conventional transcutaneous irradiation

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However, its ability to cause infection drops dramatically over time

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