Glossop N D, Jackson R W, Koort H J, Reed S C, Randle J A
Department of Orthopaedics, Baylor University Medical Center, Dallas, TX 75246, USA.
Clin Orthop Relat Res. 1995 Jan(310):72-81.
This review details clinical and laboratory experience with the 308 nm XeCl excimer laser. This ultraviolet laser is not approved yet for use in arthroscopy, but has been shown to be extremely proficient for debridement of degenerate articular cartilage and meniscus. It has fewer advantages than conventional techniques for synovectomy, meniscectomy, and lateral release. Preliminary in vitro and in vivo studies were performed to investigate the character of laser-irradiated articular cartilage and to search for evidence of regeneration. A model of arthritis was created in rabbits to test the effects of the laser. Partial-thickness cuts in articular cartilage also were irradiated to test for cartilage regeneration. In vitro results indicated that the cartilage was sealed, with only a negligible loss in thickness. The results of live rabbit studies initially showed a similar sealing under scanning electron and light microscopy; however, it tended to break down in time. The results of autoradiographic and histologic studies showed no evidence of cartilage regeneration. Recent evidence suggests that the laser may adversely affect chondrocyte vitality in a region beyond the region of visible damage. There is no evidence to suggest that the laser is mutagenic.
本综述详细介绍了308纳米氙氯准分子激光的临床和实验室经验。这种紫外线激光尚未被批准用于关节镜检查，但已被证明在清除退变的关节软骨和半月板方面极为有效。在滑膜切除术、半月板切除术和外侧松解术中，它比传统技术的优势更少。进行了初步的体外和体内研究，以研究激光照射关节软骨的特性，并寻找再生证据。在兔子身上建立了关节炎模型来测试激光的效果。还对关节软骨的部分厚度切口进行了照射，以测试软骨再生情况。体外结果表明，软骨被封闭，厚度损失可忽略不计。活体兔子研究结果最初在扫描电子显微镜和光学显微镜下显示出类似的封闭情况；然而，随着时间的推移它往往会分解。放射自显影和组织学研究结果未显示软骨再生的证据。最近的证据表明，激光可能会对可见损伤区域以外的区域的软骨细胞活力产生不利影响。没有证据表明激光具有致突变性。
