Does the Holmium:Yag laser cause osteonecrosis?
Some authors have reported a few cases of paraarticular osteonecrosis following arthroscopic knee surgery in which laser was used to assist in the treatment of cartilage and meniscal pathology. We performed a prospective randomized clinical study to determine if osteonecrosis occurs after arthroscopic laser surgery. Fifty-five patients with cartilage problems in their knee joints were randomized into two groups: the laser group included 30 patients and the conventionally instrumented group consisted of 25 patients. Power settings for the Holmium:YAG laser were 0.5 to 1.5 joules per pulse and 5 and 25 Hertz. Total energy used for the procedures was 1 to 2 K joules. Magnetic resonance imaging was performed on all patients preoperatively and postoperatively (in third, sixth, and thirteenth months). None of the patients had osteonecrosis following arthroscopic laser surgery. When the Holmium:YAG laser is used at an optimal dosage (optimal joule and Hertz) with an optimal technique (keeping the handpiece at an appropriate angle and distance) and for an optimal time (avoiding overtreatment), it does not cause osteonecrosis.
Atik
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Department of Orthopaedic Surgery, Gazi University Medical School, Ankara, Turkey.
Tali
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D001182:Arthroscopy; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006695:Holmium / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D053685:Laser Therapy / Q000009:adverse effects* / Q000295:instrumentation; D008297:Male; D008592:Menisci, Tibial / Q000473:pathology / Q000601:surgery*; D010020:Osteonecrosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment
D006695:Holmium