Background: Osteoarthritis is a common cause of chronic pain and disability in elderly people.

Objective: To evaluate the efficacy of low-level laser therapy (LLLT) in combination with Maitland mobilization and conventional physical therapy in patients with chronic knee osteoarthritis.

Design: Pre-test post-test randomized control trial.

Knee OA is associated with pain and disability, high treatment costs, decreased productivity, and absence from work and thus has a substantial and growing burden on society Objective: To evaluate the efficacy of low-level laser therapy (LLLT) in combination with Maitland mobilization and conventional physical therapy in patients with chronic knee osteoarthritis.

Participants: Seventy five subjects of both genders with age range from 50 to 65 years, with proven bilateral knee OA diagnosed and referred by orthopaedist were recruited for the study and randomly assigned into three groups.

Inclusion Criteria:

Subjects with proven bilateral Knee OA with age range 50- 65 years according to the American College of Rheumatology criteria.

2- Only patients with X-ray stages II and III osteoarthritis selected according to Kellgren & Lawrence classification system.

3- BMI equal to or less than 30 . 4- Patients with Knee pain lasted at least 6 months with intensity at least 3 on VAS scale in activities such as going up-and downstairs, sitting and squatting.

5- Patients with normal mental state. 6- Patients who are not participating in physical therapy in the recent 3 months.

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Exclusion Criteria:

1. Patient with history of gout, infection, tumour, autoimmune diseases, trauma or other causes of knee pain or knee deformities.
2. Patient with neurologic dysfunction, or with history of chronic disease that may affect the study.
3. Patient with history of knee intra-articular injection in the past 6 months.