Effect of Laser in Arthroscopic Knee Surgery

Abstract

1068 Laser technology has come into common use in orthopaedics over the last 10–15 years. The most commonly used laser in orthopaedics is the Holumim:YAG (Ho: YAG) (laser). PURPOSE: To review the clinical outcomes of laser vs. non-laser meniscectomy and chondroplasty using subjective rating scales and radiographic analysis. METHODS: This was a retrospective study of patients who had undergone arthroscopic meniscectomy, with or without chondroplasty, by a single surgeon with a minimum 2 years follow-up. Patients were subjectively evaluated with the Lysholm Knee Score and SF-36. In addition, AP and lateral radiographs were obtained at follow-up and compared to preoperative radiographs which were evaluated in a blinded manner and evaluated for joint space narrowing in the medial and lateral compartments of the knee. Statistical analysis between the laser and non-laser groups was performed using student t-test with the level of significance set at p<0.05. RESULTS: Functional results were available on 81 patients, 48 laser and 33 non-laser (mean age at surgery 52.1 ± 12.8 yrs and 47.5 ± 19.6 yrs, respectively). At an average follow-up of 35.9 ± 10.6 months for the laser group and 38.9 ± 12.8 months for the non-laser, the average Lysholm knee scores were 77.45 and 81.80, respectively (p = 0.38). In each of the eight categories of the SF-36 outcome evaluation, there were no statistically significant differences between the laser and non-laser groups. Radiographic analysis was available on 40 patients at the time of follow-up (23 laser patients and 17 non-laser patients). For the medial compartment of the knee, the average decrease in joint space was 0.87mm in the laser group versus 0.26mm in the non laser group (p = 0.09). For the lateral compartment, the average change in joint space was −0.04 mm in the laser group versus −0.35 mm in the non laser group (p = 0.20). No evidence of osteonecrosis of the femoral condyles was seen in either group. CONCLUSIONS: Overall, the results indicate that laser use in the knee for meniscectomy is as safe and as effective as traditional meniscectomy. Although slightly more expensive, the laser becomes an especially valued and effective tool in the tight knee with difficult to reach spaces.