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Laser-assisted arthroscopic ulnar shortening.

Daniel J Nagle1, Matthew A Bernstein

  • 1Department of Orthopaedic Surgery, Northwestern University, Chicago, Illinios, USA. oogien@aol.com

Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association
|November 12, 2002
PubMed
Summary

This study evaluated Ho:YAG laser-assisted arthroscopic ulna shortening for ulnocarpal abutment syndrome (UAS). Results showed similar outcomes to other procedures, with no hardware removal needed and efficient tissue removal by the laser.

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Area of Science:

  • Orthopedic Surgery
  • Minimally Invasive Procedures
  • Laser Technology in Medicine

Background:

  • Ulnocarpal abutment syndrome (UAS) treatment focuses on unloading the ulnocarpal joint.
  • Traditional ulnar shortening osteotomy (USO) yields good results but often requires hardware removal.
  • Arthroscopic wafer procedures and open wafer procedures have shown comparable outcomes to USO.

Purpose of the Study:

  • To evaluate the efficacy of arthroscopic ulnar shortening using the holmium:yttrium-aluminum-garnet (Ho:YAG) laser for UAS treatment.
  • To compare Ho:YAG laser-assisted arthroscopic ulnar shortening outcomes with existing surgical methods.

Main Methods:

  • Retrospective review of 11 patients undergoing Ho:YAG laser-assisted arthroscopic distal ulnar resection by a single surgeon (1994-2000).

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  • Evaluation based on Darrow's criteria with an average follow-up of 31 months.
  • Analysis of return to work times and complications.

    • Main Results:

    • 64% excellent, 18% good, 9% fair, and 9% poor results according to Darrow's criteria.
    • Average return to work was 4.7 months.
    • Complications included repeat surgery for scar formation, transient tendonitis, and portal site erythema; no hardware-related issues occurred.

    Conclusions:

    • Ho:YAG laser-assisted arthroscopic ulna shortening provides outcomes comparable to arthroscopic wafer procedures, open wafer procedures, and USO.
    • This technique offers advantages such as avoiding hardware removal and efficient bone and cartilage resection.
    • Return to work and occupation rates are similar to previously reported findings.