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Proceedings Paper

Effects of Nd:YAG laser on the meniscus of the knee joint
Author(s): Jan Fronek M.D.; Joel Krakaver; Clifford W. Colwell M.D.
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Paper Abstract

The use of laser energy for arthroscopic surgery of the meniscus has been fraught with difficult problems which include excessive tissue penetration and the need for a gas medium. The use of the Neodynium : Yttrium Aluminum Garnet (Nd:YAG) laser offers better control of the penetration depth as well as the opportunity to operate the laser in a liquid medium. Twenty-two excised menisci and twenty cadaver knee menisci were exposed to contact Nd:YAG laser radiation of a power density at 1 .064 microns. The operating parameters included a range of power levels of 5 to 60 watts and exposure time of 0.5 to 1 0.0 seconds. The laser-induced dissection yielded reproducible layers of cavitation and necrosis, proportional to the power and duration of the beam. Carbonized debris was noted on the edge of the cut surface, particularly at the higher power setting. The more peripheral zone of coagulation remained at constant depth and width when tested within the parameters noted above. The Nd:YAG laser has been observed to section the meniscus cartilage in a very controlled, accurate and safe fashion. For the best tissue effect, impulses of 1 5 - 20 watts applied for 2-4 seconds offer the most efficacious combination for the knee menisectomy. While these findings are promising for the clinical utilization of Nd:YAG laser in arthroscopic surgery, additional work is required on both the technical aspects of the sapphire tip design as well as the longterm sequellae of the laser treated cartilage.

Paper Details

Date Published: 1 June 1990
PDF: 7 pages
Proc. SPIE 1200, Laser Surgery: Advanced Characterization, Therapeutics, and Systems II, (1 June 1990); doi: 10.1117/12.17463
Show Author Affiliations
Jan Fronek M.D., Scripps Clinic and Research Foundation (United States)
Joel Krakaver, Scripps Clinic and Research Foundation (United States)
Clifford W. Colwell M.D., Scripps Clinic and Research Foundation (United States)

Published in SPIE Proceedings Vol. 1200:
Laser Surgery: Advanced Characterization, Therapeutics, and Systems II
Stephen N. Joffe M.D.; Kazuhiko Atsumi M.D., Editor(s)

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