Inclusion Criteria:

BMI less than or equal to 45

Currently set up for an elective primary total knee arthroplasty due to primary osteoarthritis

Ability to provide informed consent to participate in the clinical trial

Ability to understand and communicate in English

Willingness to comply with all study procedures

Exclusion Criteria:

• poorly controlled comorbidities that would not allow surgical intervention such as poorly controlled diabetes (HbA1C > 8.0) renal insufficiency (eGFR <60) poorly controlled CV disease such as CHF that is NYHA class 3 and 4
• inability to receive the intervention including contraindications and/or known photosensitivity.
• patients with history of total joint infection ever or any infection in the last 6 months
• ASA score >3 and Outpatient Arthroplasty Risk Assessment (OARA; medical risk stratification scoring system to help determine day surgery vs inpatient)1 score > 80.
• previous PBMT treatment within 3 months from the start of the study for the participant.
• utilization of supplemental/holistic methods specifically for pain control (e.g. cannabidiol). This will be discontinued 30 days prior to TKA and will not be used during the duration of study participation. This will be evaluated by the Principal Investigator and study team prior to consent.
• significant anti-coagulation usage (other than aspirin) 7 days prior to treatment
• CV surgery within the last 6 months
• significant neurologic compromise (acquired or congenital/genetic) of the lower extremity to be operated on or underlying neurologic condition that would confound results in the opinion of the investigator such as a previous brachial plexus injury after a motor vehicle accident or myasthenia gravis
• regular opioid use prior to surgical intervention as defined as >20 MME per day for 30 days prior to enrollment.
• Intolerance/allergy to hydrocodone or codeine
• significant physical deformity of the planned operative extremity that would confound the results in the opinion of the investigator(s)
• Immunocompromised patients, that in the opinion of the investigators, would confound the patient's ability to heal such as rheumatoid arthritis patient taking immunosuppressants.
• females who are pregnant or who are expecting to be pregnant for the duration of the study
• any tattoos or other permanent markings located on the treatment area

Male patients or female who are not pregnant and do not plan on future pregnancy during trial participation, between 30-65 years of age

Exclusion Criteria:

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