[Open laser surgery on the locomotor apparatus]

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Laser Technology

Background:

• Early laser applications in locomotor surgery focused on hemostasis for hemophiliacs.
• The development of pulsed holmium:YAG lasers enabled use in fluid media with minimal side effects.
• Understanding biophysical mechanisms now supports infrared laser use in open orthopedic surgery.

Purpose of the Study:

• To evaluate the efficacy and safety of open laser surgery for various locomotor system indications.
• To assess the benefits of laser's hemostatic, ablative, and shrinking properties in open procedures.
• To investigate the analgesic effect and long-term outcomes of laser treatment in orthopedic patients.

Main Methods:

• A prospective clinical study involving 30 patients undergoing open laser surgery.
• Utilized laser for hemostatic tissue ablation in synovectomy, bone resections (osteophytes, osteochondromas), osteoid osteoma, and sacral hyperplasia.
• Applied non-ablative shrinking for soft tissue resections (e.g., jumper's knee, tennis elbow) and spinal decompression.

Main Results:

• Laser facilitated easier shaping with eliminated bleeding during bony resections.
• Non-ablative shrinking resulted in less tissue loss and stabilized soft tissue margins.
• Postoperative analgesic drug administration averaged 3 days, indicating an analgesic effect.
• At 12-21 months follow-up, 25/30 patients showed complete or near-total healing, with 3 showing significant improvement.

Conclusions:

• Open laser surgery is a safe and effective treatment for diverse orthopedic conditions.
• Laser technology offers advantages in hemostasis, tissue ablation, and soft tissue management.
• The observed analgesic effect and high success rate warrant further long-term investigation.