V. Baskov (Moscow, RU)
OrthospinePresenter Of 1 Presentation
18.3.5 - Regeneration of hyaline cartilage in joints using minimally invasive fractional laser procedure
Abstract
Purpose
Investigate Ex-vivo, in an animal study, and in a human clinical study feasibility of using minimally invasive fractional laser procedure to induce cartilage regeneration in patients suffering from osteoarthritis of the knee.
Methods and Materials
Erbium fiber laser emitting at the wavelength of 1560 nm was used in all treatments. Laser energy was delivered to the target site through optical fiber. Ex-vivo, bovine joints were used to investigate temperature rise and tissue damage resulting from laser illumination. In mini-pig animal model, excisional defects with a size of 4–12 mm, depth of 0.5–0.6 mm (partial- thickness lesions) were created on the head of femoral bones (hind legs) of 20 animals. For each animal, an extremity was laser-treated while the contralateral one was left as control. Clinical study was conducted on 12 subjects with osteoarthritis Stage II to III. Laser energy was delivered via surgical arthroscope. All patients received a single treatment. MRI, range of motion, pain, and gait assessments were used for evaluation.
Results
Ex-vivo data has demonstrated that clinically relevant laser parameters induced temperature rise not exceeding 55 ⁰C. It the animal study, majority of the laser-irradiated defects were filled with hyaline-like cartilage in two-three months, in contrast to untreated sites. The restoration of lamina splendens was observed in 60 percent of laser-treated defects. In the clinical study, MRI examinations before and after laser surgery have revealed restoration of the cartilage plate tissue by 1 – 2 mm. For 91% of the patients the results of the dynamic (range of motion) tests have demonstrated essential reduction of the pain syndrome and improved functionality of the joints on 12 months follow-up. 
Conclusion
Pre-clinical and clinical results suggest that minimally invasive fractional laser treatment may be a viable procedure for treating mild-to-moderate osteoarthritis of the knee.