Holmium - YAG Laser 를 이용한 반월상 연골 부분절제술후 절제면의 재생정도 = The Histologic Changes after Partial Meniscectomy Using Holmium - YAG Laser

다국어 초록 (Multilingual Abstract)

It had been known that the meniscus has the capability of repair and regeneration only within the territory of peripheral vascular or red zone but not in the avascular or white zone. But, with the development of arthroscopic surgery, some evidences about the remode1ing process was found in the avascular zone of the meniscus after partial meniscectomy. It was postulated that fibrin clot was incooperated with fihrohlasts and then eventually l.uiaed into a f'ibrocartilagenous tissue in some reports. Since early 1980, arthroscopic laser surgery has introduced for an easy assess to tight joint spaces and prec;ise tissue ablation. Rut the arthroscopic Jaser surgery has considerable thermal injuip which may result in adverse effccts on the regeneration process. Therefore this study was performed to investigate the regeneration potential in the avascular zone of meniscus and to compare lhe regeneration process after partial meniscectomy hy the laser and the mechanical instruments. The authors have undertaken an experimenta1 study upon rnorphological changes of the meniscectomy surface af'ter mechanical and laser meniscectomy at the avascular zone of the medial meniscus. The results were as follows 1. Following mechanical meniscectomy (Group l), remodeling at the cut surface of the meniscus was demonstrated in 19 of the 30 rahbits (63%). The shape of regeneration tissue appeared nonnal and the meniscectomy defect were reconstructed effectively hy the remodeling process. 2. Atfter meniscectomy using Holmium-YAG laser(Group ii), 14 of 30 rabbits(47%) demonstrated remodeling. But the shape of the regeneration tissue appemed to be irregular and it has failed to reconstruct the meniscectomy defect effectively. 3. The remodeling process of the meniscectomy surface appeared to begin with a fibrin clot which adhere to the cut surface. This process was found in hoth of the mechanical and laser meniscectomy group. But the metaplasia of the fibrous tissue into the fibrocarti1agenous one was delayed in the laser meniscectomy group. Ahove resulls suggests that the rnechanical meniscectomy is superior to the Holmium-YAG laser technique with rcspect to regeneration potential af'ter partial meniscectomy. Therefore the arthroscopic laser surgery may be limited to the lesions that is liard to be assessed by conventionai art.hroscopic instruments.