0
Articles   |    
Quantification of Laser-Induced Cartilage Injury by Confocal Microscopy in an ex Vivo Model
P. Mainil-Varlet, MDPhD; D. Monin, MD; C. Weiler, MD; S. Grogan, PhD; T. Schaffner, MD; B. Züger, MSc; M. Frenz, PhD
View Disclosures and Other Information
Investigation performed at the Institutes of Pathology and Applied Physics, University of Bern, Bern, Switzerland
P. Mainil-Varlet, MD, PhD D. Monin, MD S. Grogan, PhD T. Schaffner, MD B. Züger, MSc M. Frenz, PhD Institutes of Pathology (P.M.-V., D.M., S.G., and T.S.) and Applied Physics (B.Z. and M.F.), University of Bern, Murtenstrasse 31, CH-3010 Bern, Switzerland. E-mail address for P. Mainil-Varlet: mainil@patho.unibe.ch
C. Weiler, MD Institut für Pathologie, Institutsbereich Innenstadt, Thalkirchner Strasse 36, D-80337 Munich, Germany
In support of their research or preparation of this manuscript, one or more of the authors received grants or outside funding from the Swiss Commission for Technology and Innovation and Stiftung zur Förderung der wissenschaftlichen Forschung an der Universität Bern. None of the authors received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

J Bone Joint Surg Am, 2001 Apr 01;83(4):566-566
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case

Abstract

Background:

The application of lasers in orthopaedic surgery is increasing. However, some investigators have reported that osteonecrosis may occur after laser meniscectomy. The objective of the present study was to evaluate the effect of laser wavelength and energy on cartilage injury in an ex vivo model.

Methods:

Fresh bovine articular cartilage was exposed to either holmium:yttrium-aluminum-garnet (Ho:YAG) or erbium:YAG-laser (Er:YAG) irradiation. Both lasers were operated in a free-running mode and at a pulse-repetition rate of 8 Hz. The effect of laser treatment at several energy levels (Er:YAG at 100 and 150 mJ and Ho:YAG at 500 and 800 mJ) was examined. For each light source and energy level, ten cartilage samples were assessed by conventional histological analysis and by confocal microscopy. Thermal damage was assessed by determining cell viability.

Results:

The extent of thermal damage demonstrated by confocal microscopy was much greater than that demonstrated by histological analysis. The extent of thermal injury after Ho:YAG-laser irradiation was much greater than that after Er:YAG-laser irradiation, which was associated with almost no damage. In addition, the ablation depth was greater after treatment with the Er:YAG laser than after treatment with the Ho:YAG laser.

Conclusions:

In the present study, histological analysis underestimated thermal damage after laser irradiation. In addition, our findings highlighted problems associated with use of high-power settings of Ho:YAG lasers during arthroscopic surgery.

Clinical Relevance:

Débridement and smoothing of cartilage in patients with osteoarthritis or cartilage defects should cause minimal injury to the surrounding cartilage in order to avoid additional tissue destruction.

Figures in this Article
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

     
    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org

    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe





    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    01/22/2014
    Pennsylvania - Penn State Milton S. Hershey Medical Center
    04/16/2014
    Georgia - Choice Care Occupational Medicine & Orthopaedics
    04/16/2014
    Ohio - OhioHealth Research and Innovation Institute (OHRI)