Previous applications f laser bone and cartilage ablation have focused largely on the CO2 and the Nd:Yag lasers, using both the continuous wave and rapid superpulsed mode, which revealed severe thermal damage such as tissue necrosis and
carbonization of
the remaining tissue. In contrast, Excimer lasers have provided better histologic results with minimal or no thermal damage, but the ablation rate and cutting efficiency have remained unsatisfactory.
Though arthroscopic partial menisectomy has become the accepted technique for dealing with tears in menisci, division of the meniscus is sometimes difficult in the confined joint space of the knee and is accociated wit iatrogenic injury to the
articular
cartilage. The ability to quickly and safely divide or remove meniscal tissue would be a distinct advantage.
The Holmium: yag laser has many potential advantages over the CO2 laster, the Nd: Yag laser and the Excimer laser. Its principal advantages included minimal mechanical trauma to the articular cartilage, greater access to tight or restricted area
of
the
knee joint, and its ability to function in a saline medium and to resect meniscus with minimal tissue necrosis.
We have evaluated the effectiveness of the Holmium: Yag laser in 74 partial menisectomies of 57 patients. Among 74 meniscal tears, there were 35 medial and 39 lateral meniscal tears. The average operation time was 33 minutes in the menisectomy
and
hospital stay was average 3 days. There was no significant carbonization on the surrounding tissue. Menisectomy of the posterior horn was safe and easy and the was minimal iatrogenic articular cartilage damage.
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