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

Abstract

Abstract. 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 ¼ 2.94 μm), titanium:sapphire femtosecond laser system (λ ¼ 1700 nm), and Nd:glass femtosecond laser (λ ¼ 1053 nm). Bovine samples were ablated at fluences of 8 to 18 J∕cm 2 with the erbium:YAG laser, at a power of 300 AE 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∕cm 2 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.

In Vitro and Ectopic In Vivo Studies toward the Utilization of Rapidly Isolated Human Nasal Chondrocytes for Single-Stage Arthroscopic Cartilage Regeneration Therapy

“…Finally, in our study, graft-bone integration was rather variable, probably due to irregular amounts of hyaline/calcified cartilage tissues remaining in the osteochondral defects after their debridement with the standard ring curette [56]. In this context, the utilization of laser technology [57] to refresh cartilage defects with opto-acoustic feedback [58,59], instead of the classical surgical instrumentation used in this paper, could allow the generation of more uniform defects to test the integration properties of a cell-loaded gel at more standardized conditions in future studies.…”

Preclinical evaluation of porcine colon resection using hollow core negative curvature fibre delivered ultrafast laser pulses

“…The histology images are helpful for identifying tissue damage and ablation depth after the laser resection of colon tissue. Such histology results are used in the literature to prove the efficiency of the laser ablation . The ablation depth and width of thermal damage was analysed in relation to applied laser fluence.…”

Design of an ultrafast laser surgical probe towards maximum achievable MRR

“…Over the past decade, the integration of ultrashort laser technology into surgical tools has been a persistent pursuit. Researchers have explored its capabilities across various fronts [1][2][3][4][5] , with particular interest in bone ablation or laser osteotomy [6][7][8][9][10] . Unlike conventional mechanical methods, which suffer from poor spatial resolution and risk bone damage [11][12][13] , ultrashort laser ablation, owing to the nature of its process [17][18][19] , offers superior precision and minimal thermal impact 5,10,[14][15][16] .…”