Arthroscopic Chondroplasty in Knee, Shoulder and Ankle Joints using Holmium:YAG Laser vs Conventional Instruments (Randomized-Prospective Study)

Abstract

This clinical study was designed to compare the early results of arthroscopic chondroplasty in knee, shoulder and ankle joints that were performed using either Holmium:YAG laser or conventional instruments. Forty-eight patients with chondral problems were treated with arthroscopic surgery using Holmium:YAG laser in twenty-three patients, and conventional instruments (blades, forceps, shavers) in twenty-five patients. During these procedures, removal of cartilage tear, shaving, smoothening and joint lavage were carried out. 0.5 to 1.5 Joule energy with 10 to 30 pulse rate was used in Holmium group. The mean follow-up period was fourteen months. There were no serious complications in both groups. Bleeding and swelling was less in the Holmium group. Laser probe was inserted into narrow joint spaces and worked without trauma caused by mechanical and monitored instruments. Contouring and smoothening were more precise in the Holmium group. It is concluded that, Holmium:YAG pulsed laser has more potential advantages over conventional instruments, including to reach into narrow joint spaces, to coagulate, chondral scuffing and without injury to adjacent healthy tissue or without excessive tissue removal.