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KMID : 0359619960080010009
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Journal of Korean Knee Society
1996 Volume.8 No. 1 p.9 ~ p.17
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The Histologic Changes after Partial Meniscectomy Using Holmium -YAG Laser
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오종건
박정호/채인정/변영수/윤태일
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Abstract
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It had known that the meniscus has the capability of repair and regdeneration only within the territory of peripheral vascular or red zone but not in the avascular or white zone But, with the development of arthroscopic surgery, some evidences
about the
remodeling process was found in the avascular zone of the meniscus after partial meniscectomy. It was postulated that fibrin clot was incooperated with fibroblasts and then eventually turned into a fibrocartilagenous tissue in some reports. Since
early 1980, arthroscopic laser surgery has introduced for an easy assess to tight joint spaces and precise tissue ablation. But the arthroscopic laser surgery has considerable thermal injury which may result in adverse effects on the regeneration process.
Therefore this study was performed to investigate the regeneration potential in the avascular zone of meniscus and to compare the regeneration process after partial meniscectomy by the laser and the mechanical instruments. The authors have
undertaken an experimental study upon morphological changes of the meniscectomy surface4 after mechanical and laser meniscectomy at the avascular zone of the medial meniscus. The results were follows
1. Following mechnanical meniscectomy (Group I), remodeling at the cut surface of the meniscus was demonstrated in 19 of the 30 rabbits (63%). The shape of regeneration tissue appeared normal and the meniscectomy defect were reconstructed
effectively by the remodeling process.
2. Atfter meniscectomy using Holmium-YAG laser(Group II), 14 of 30 rabbit(47%) demonstrated remodeling. But the shape of the regeneraion tissue appeared to be irregular and it has failed to reconstruct the meniscectomy defect effectively.
3. The remodeling process of the meniscectomy surface appeared to begin with a fibrin clot which adhere to the cut surface. The process was found in both of the mechanical and laser meniscectomy group. But the metaplasia of the fibrous tissue
into
the
fibrocartilagenous one was delayed in the laser meniscectomy group.
Above results suggests that the mechanical meniscectomy is superior to the Holmium-YAG laser technique with respect to regeneration potential after partial meniscectomy. Therefore the arthroscopic laser surgery may be limited to the lesions that
is
hard
to be assessed by conventional arthroscopic instruments.
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KEYWORD
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