Arthroscopic shoulder surgeyr with three different laser systems: An evaluation of laser applications |
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| Authors: | C. Thomas Vangsness Jr. M.D. Chadwick F. Smith M.D. |
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| Affiliation: | 1. National Hellenic Research Foundation, Theoretical and Physical Chemistry Institute, Vass. Constantinou Ave., 48, 116-35 Athens, Greece;2. University of Sfax, Laboratoire de Physique Appliqué, Faculté des Sciences de Sfax, BP 1171 Sfax, Tunisia;3. NCSR, Demokritos, Institute of Nanoscience and Nanotechnology, 15310 Aghia Paraskevi, Attiki, Greece;1. Materials Science Department, School of Natural Sciences, University of Patras, 26504, Greece;2. Center for Technology Research & Innovation (CETRI) Ltd, Thessalonikis 1 Str. – Nicolaou Pentadromos Center, Limassol 3025, Cyprus;1. Upper Limb Unit, F MIULLI Hospital, Acquaviva delle fonti Ba, Italy;2. Radiology Unit, F MIULLI Hospital, Acquaviva delle fonti, Acquaviva delle fonti Ba, Italy;3. Shoulder and Elbow Unit, IRCCS Humanitas Institute, Milan, Italy;4. Shoulder Unit, Gavazzeni Bergamo, Italy;5. The Shoulder Center Baylor University Medical Center, Dallas, USA |
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| Abstract: | Twelve cadaveric shoulder arthroscopies were performed to evaluate the use of lasers as an adjunctive tool in arthroscopic shoulder surgery. The three most common lasers historically used in orthopedic surgery were examined: Holmium:YAG, Neodymium:YAG, and the CO2. The following parameters were evaluated for each laser system: (1) each of use of the laser system and handpiece; (2) ability to excise and trim bursae, synovium, ligament, tendon, bone, and articular cartilage; and (3) ability to contract ligaments and capsule by heat transfer. None of these lasers efficiently cut bone, whereas all three systems readily debrided the soft tissues around the shoulder. The free-beam Ho:YAG and CO2 systems heat contracted soft tissues with more control than the contact Nd:YAG. The fiberoptic delivery system of the Neodymium:YAG and Holmium:YAG laser performed well in the saline arthroscopy, and the CO2 delivery system was cumbersome. Overall, the CO2 system removed tissue better than the others, but its difficult use favored the Holmium laser as the best overall current laser system for shoulder arthroscopy. |
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| Keywords: | Laser Shoulder Ablation Capsular/ligament shrinking |
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