Electron microscopy of CO2-laser-induced effects in human fibrocartilage

Previous reports of effects of CO2 laser energy on human fibrocartilage suggest thermal injury extends to a depth of approximately 70 microns from the target surface with power settings of 35 W and exposure times of 0.5 seconds. The present study was undertaken to look for more subtle evidence of thermal alteration of human fibrocartilage treated with CO2 laser irradiation. Fifteen human menisci were irradiated at power settings of 10, 20, and 30 W with exposure times of 0.1 and 0.5 seconds. The specimens were immediately fixed and sectioned for electron microscopic examination. Loss of a normal cross banding, and marginal clarity of individual collagen fibers were observed in the extracellular matrix and were observed at distances up to 300 microns from the exposed tissue surface. In addition, cellular changes at similar tissue depth consisted of cell membrane invaginations, clumping of nuclear chromatin, breakdown of endoplasmic reticulum architecture, and loss of mitochondria and Golgi complexes from the cytoplasm were observed. This study demonstrates deeper penetration of a radiation that was previously appreciated by light microscopy in irradiated human fibrocartilage, although the implications with respect to contraside viability and healing potential of the tissue in vivo is not known.