title: Delayed articular cartilage slough: two cases resulting from holmium:YAG laser damage to normal articular cartilage and a review of the literature.
abstract: We present two cases referred from other physicians with chondral damage and cartilage slough secondary to use of the holmium:YAG laser during knee arthroscopy. The first patient had a partial lateral meniscectomy, which was done with a 20-W Ho:YAG laser. The patient never fully recovered and underwent a second arthroscopy that revealed full-thickness cartilage defects of the lateral femoral condyle. The second patient had debridement of Outerbridge grade III changes of the lateral tibial plateau and patella, as well as a partial lateral meniscectomy using a Ho:YAG laser. The patient developed recurrent symptoms, and when a second arthroscopy was performed, new degenerative changes to the lateral femoral condyle were noted with large areas of cartilage loss. A careful look needs to be taken at the limited use of lasers until further randomized prospective studies are carried out comparing patient outcomes, cost, and long-term complications.
authors.affiliation: Town Center Orthopaedic Associates, Reston, VA 22090, USA.
authors.forename: R
authors.initials: R
authors.lastname: Thal
authors.forename: M B
authors.initials: MB
authors.lastname: Danziger
authors.forename: A
authors.initials: A
authors.lastname: Kelly
mesh_terms: D000328:Adult; D020679:Arthroscopes; D002358:Cartilage, Articular / Q000293:injuries* / Q000473:pathology / Q000601:surgery; D003646:Debridement; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D007834:Lasers / Q000009:adverse effects*; D008592:Menisci, Tibial / Q000473:pathology / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D012008:Recurrence; D012086:Reoperation; D000070600:Tibial Meniscus Injuries