Preclinical investigations of articular cartilage ablation with femtosecond and pulsed infrared lasers as an alternative to microfracture surgery

• Published in: Journal of biomedical optics Vol. 19; no. 9; p. 098001
• Main Authors: Su, Erica, Sun, Hui, Juhasz, Tibor, Wong, Brian J. F
• Format: Journal Article
• Language: English
• Published: United States Society of Photo-Optical Instrumentation Engineers 01.09.2014
• Subjects: Ablation; Animals; Bones; Cartilage; Cartilage, Articular - pathology; Cartilage, Articular - physiology; Cartilage, Articular - radiation effects; Cattle; Femtosecond; Hydration; Instrumentation; Laser Therapy - instrumentation; Lasers; Microfracture; Research Papers: Therapeutic; Surgery; hard tissue ablation; femtosecond laser; knee cartilage; microfracture surgery
• ISSN: 1083-3668; 1560-2281
• DOI: 10.1117/1.JBO.19.9.098001

Microfracture surgery is a bone marrow stimulation technique for treating cartilage defects and injuries in the knee. Current methods rely on surgical skill and instrumentation. This study investigates the potential use of laser technology as an alternate means to create the microfracture holes. Lasers investigated in this study include an erbium:YAG laser (λ=2.94  μm), titanium:sapphire femtosecond laser system (λ=1700  nm), and Nd:glass femtosecond laser (λ=1053  nm). Bovine samples were ablated at fluences of 8 to 18  J/cm2 with the erbium:YAG laser, at a power of 300±15  mW with the titanium:sapphire femtosecond system, and at an energy of 3  μJ/pulse with the Nd:glass laser. Samples were digitally photographed and histological sections were taken for analysis. The erbium:YAG laser is capable of fast and efficient ablation; specimen treated with fluences of 12 and 18  J/cm2 experienced significant amounts of bone removal and minimal carbonization with saline hydration. The femtosecond laser systems successfully removed cartilage but not clinically significant amounts of bone. Precise tissue removal was possible but not to substantial depths due to limitations of the systems. With additional studies and development, the use of femtosecond laser systems to ablate bone may be achieved at clinically valuable ablation rates.