Pulsed CO2 laser for intra-articular cartilage vaporization and subchondral bone perforation in horses

Alan J. Nixon D.V.M.; Jerry E. Roth; Lennart Per Krook

doi:10.1117/12.44007

1 May 1991 Pulsed CO₂ laser for intra-articular cartilage vaporization and subchondral bone perforation in horses

Alan J. Nixon D.V.M., Jerry E. Roth, Lennart Per Krook

Proceedings Volume 1424, Lasers in Orthopedic, Dental, and Veterinary Medicine; (1991) https://doi.org/10.1117/12.44007
Event: Optics, Electro-Optics, and Laser Applications in Science and Engineering, 1991, Los Angeles, CA, United States

Abstract

A pulsed carbon dioxide laser was used to vaporize articular cartilage in four horses, and perforate the cartilage and subchondral bone in four horses. Both intercarpal joints were examined arthroscopically and either a 1 cm cartilage crater or a series of holes was created in the third carpal bone of one joint. The contralateral carpus served as a control. The horses were evaluated clinically for 8 weeks, euthanatized and the joints examined radiographically, grossly, and histologically. Pulsed carbon dioxide laser vaporized cartilage readily but penetrated bone poorly. Cartilage vaporization resulted in no greater swelling, heat, pain on flexion, lameness, or synovial fluid reaction than the sham procedure. Laser drilling resulted in a shallow, charred hole with a tenacious carbon residue, and in combination with the thermal damage to deeper bone, resulted in increased swelling, mild lameness and a low-grade, but persistent synovitis. Cartilage removal by laser vaporization resulted in rapid regrowth with fibrous and fibrovascular tissue and occasional regions of fibrocartilage at week 8. The subchondral bone, synovial membrane, and draining lymph nodes appeared essentially unaffected by the laser cartilage vaporization procedure. Conversely, carbon dioxide laser drilling of subchondral bone resulted in poor penetration, extensive areas of thermal necrosis of bone, and significant secondary damage to the apposing articular surface of the radial carpal bone. The carbon dioxide laser is a useful intraarticular instrument for removal of cartilage and has potential application in inaccessible regions of diarthrodial joints. It does not penetrate bone sufficiently to have application in subchondral drilling.

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Alan J. Nixon D.V.M., Jerry E. Roth, and Lennart Per Krook "Pulsed CO₂ laser for intra-articular cartilage vaporization and subchondral bone perforation in horses", Proc. SPIE 1424, Lasers in Orthopedic, Dental, and Veterinary Medicine, (1 May 1991); https://doi.org/10.1117/12.44007

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KEYWORDS

Bone

Cartilage

Carbon dioxide lasers

Laser drilling

Tissues

Carbon

Natural surfaces

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