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Does the Holmium:Yag laser cause osteonecrosis?
1Department of Orthopaedic Surgery, Gazi University Medical School, Ankara, Turkey.
Bulletin (Hospital for Joint Diseases (New York, N.Y.))
|October 6, 1999
Summary
Arthroscopic laser surgery for knee cartilage and meniscus issues did not cause osteonecrosis (bone death) in a study. Proper technique and energy levels with the Holmium:YAG laser are key to safe treatment.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Medical Imaging
Background:
- Paraarticular osteonecrosis has been anecdotally reported after arthroscopic knee surgery using lasers.
- The specific risk of osteonecrosis following laser-assisted arthroscopic procedures for cartilage and meniscal pathology requires further investigation.
Purpose of the Study:
- To prospectively evaluate the incidence of osteonecrosis after arthroscopic laser surgery for knee cartilage pathology.
- To compare outcomes between laser-assisted and conventional arthroscopic interventions.
Main Methods:
- A prospective randomized clinical study involving 55 patients with knee cartilage problems.
- Patients were randomized into a Holmium:YAG laser group (30 patients) or a conventional instrument group (25 patients).
- Magnetic resonance imaging (MRI) was used for preoperative and serial postoperative assessments at 3, 6, and 13 months.
Main Results:
- No cases of osteonecrosis were observed in any patient following arthroscopic laser surgery.
- The study utilized specific power settings (0.5-1.5 J/pulse, 5-25 Hz) and total energy (1-2 kJ) for the Holmium:YAG laser procedures.
Conclusions:
- Arthroscopic laser surgery, when performed with optimal Holmium:YAG laser parameters (dosage, technique, time), does not appear to cause osteonecrosis.
- This suggests that laser-assisted arthroscopic procedures can be a safe option for treating knee cartilage and meniscal pathology.