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Pulsed Carbon Dioxide Laser for Cartilage Vaporization and Subchondral Bone Perforation in Horses Part I: Technique and Clinical Results
Author(s) -
ROTH JEROME E.,
NIXON ALAN J.,
GANTZ VALERIE A.,
MEYER DENNIS,
MOHAMMED HUSSNI
Publication year - 1991
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/j.1532-950x.1991.tb00334.x
Subject(s) - medicine , cartilage , vaporization , perforation , subchondral bone , carbon dioxide laser , articular cartilage , laser , anatomy , pathology , laser surgery , composite material , osteoarthritis , optics , physics , alternative medicine , thermodynamics , materials science , punching
A carbon dioxide laser, used in a rapidly pulsed mode, was evaluated for intra‐articular use in horses. Under arthroscopic guidance, a lensed 5 mm laser probe attached directly to a hand‐held carbon dioxide laser was inserted into one intercarpal joint of eight horses. In four horses, a cartilage crater 1 cm in diameter was created to the level of the subchondral bone of the articular surface of the third carpal bone. In four horses, the laser was directed perpendicular to the articular surface of the third carpal bone and activated to penetrate the cartilage and subchondral bone. The intercarpal joint of the opposite carpus in each horse was subjected to arthroscopic examination and insertion of the laser probe for an equivalent time. The laser was not activated and these joints served as sham operated controls. The horses were evaluated clinically for 8 weeks, then euthanatized, and the joints were 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. The carbon dioxide laser is a useful intra‐articular 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.