Acute and chronic response of articularcartilage to ho:yag laser irradiation

A Ho:YAG laser system operating at a wavelength of 2. 1 microns has recently been introduced for use in arthroscopic surgery. The acceptability of this new tool will be determined not only by its ability to resect tissue, but also by its long term effects on articular surfaces. In order to investigate these issues further, we performed two studies to evaluate the acute and chronic effects of the laser on cartilagenous tissue. We evaluated the acute, in vitro effects of 2.1 micron laser irradiation on articular and fibrocartilage. This included the measurement of ablation efficiency, ablation threshold and thermal damage in both meniscus and articular cartilage. To document the chronic effects on articular cartilage in vivo, we next performed a ten week healing study. Eight sheep weighing 30-40 kg underwent bilateral arthrotomy procedures. Multiple full thickness and partial thickness defects were created. Animals were sacrificed at 0, 2, 4, and 10 weeks. The healing study demonstrated a) no healing of full or partial thickness defects at 10 weeks with hyaline cartilage; b) fibrocartilagenous granulation tissue filling full thickness defects at two and four weeks, but no longer evident at ten weeks; c) chondrocyte necrosis extending to greater than 900 microns distal to ablation craters at four weeks with no evidence of repair at later dates; d) chondrocyte hyperplasia at the borders of the damage zone at two weeks but no longer evident at later sacrifice dates.