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    Histological alterations after irradiation of cartilage using Ho: YAG laser
    (Mary Ann Liebert Inc Publ, 2003) Atik, O. Sahap; Erdoğan, Deniz; Ömeroğlu, Suna; Korkusuz, Feza; Uslu, Murad M.; Eksioglu, Fatih
    The authors carried out an experimental study to evaluate the histological alterations after irradiation of cartilage using Holmium:YAG (Ho:YAG) laser VersaPulse Select 60 watts and Infra. Tome Delivery Systems 30degrees Handpiece (spot size at fiber tip 0.4 mm; Coherent Medical, Palo Alto, CA). Background Data: Recently, some authors reported cases with articular cartilage damage following arthroscopic laser surgery in the knee joint for the treatment of articular cartilage or meniscal pathology. Materials and Methods: The cartilage specimens immersed in saline were exposed to Ho:YAG laser irradiation. The laser wavelength was 2.1 mum, and pulse duration was 250 musec. Power settings were 0.2-1 joules per pulse and 10-15 Hz. Total laser energy used in these procedures was 1.5 K joules. During the procedures, the handpiece was used at an angle of 30degrees and at a distance of 1 mm. Results: Electron microscopic evaluation demonstrated that the ultrastructure of the cartilage is preserved in both experiment and control groups. Conclusion: When Ho:YAG laser is used in optimal dosage (optimal joule and Hertz) with optimal technique (keeping the handpiece at an appropriate angle and distance) and avoiding overtreatment, it does not cause cartilage damage.
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    Histological and magnetic resonance imaging alterations after irradiation of meniscus using holmium: YAG laser
    (Mary Ann Liebert Inc Publ, 2001) Atik, O. Sahap; Erdogan, Deniz; Ömeroğlu, Suna; Tali, Turgut; Korkusuz, Feza; Uslu, M. Murad; Eksioglu, Fatih
    Objective: The authors performed an experimental and a prospective clinical study to evaluate the histological and magnetic resonance imaging (MRI) alterations after irradiation of meniscus using holmium:YAG (Ho:YAG) laser VersaPulse Select 60 watts and InfraTome Delivery Systems 30 degrees Handpiece (spot size at fiber tip 0.4 mm; Coherent Medical, Palo Alto, CA). Background Data: Recently, some authors reported a few cases with articular cartilage damage or paraarticular osteonecrosis following arthroscopic knee surgery in which the laser was used to assist in the treatment of meniscal pathology. Methods: Meniscus specimens in saline immersion were exposed to Ho:YAG laser irradiation. The laser wavelength was 2.1 mum and pulse duration was 250 mu sec. Power settings were 1-1.5 joules per pulse and 10-15 Hz. Total laser energy used in these procedures was 2, 3.5, and 6 K joules. Eight patients with meniscal problems underwent arthroscopic partial meniscectomy using Ho:YAG laser. Total laser energy used for these surgeries was 1.5-2.5 K joules. MRI was performed preoperatively and at 6 months postoperatively. Results: At higher energy levels (more than 3 K joules), separation of the gap between the collagen fibers, and a three-dimensional dispersion in the striation were observed on electron microscopic evaluation of meniscus specimens. No patient had abnormal signals in MRI (a sign of articular cartilage damage or osteonecrosis) following arthroscopic laser surgery. Conclusion: When higher energy level is required, conventional instruments should be preferred in the treatment of meniscal lesions. Laser should be reserved for the posteriorly located and smaller meniscal lesions.
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    The Use of Computed Tomography to Determine Femoral Component Size A Study of Cadaver Femora
    (J Michael Ryan Publishing Inc, 2005) Uslu, Murad; Özsar, Barış; Kendi, Tuba; Kara, Simay; Tekdemir, İbrahim; Atik, O. Sahap
    Computed tomography is used to assess whether ideal femoral component size in knee arthroplasty can be made more accurately. Ideal femoral component size was measured on radiography, computed tomography, and by direct measurement of 20 cadaver femora and analyzed statistically. There was no significance between the tomographically anticipated ideal femoral component size and ideal femoral size values (Wilcoxon W 388.5; p 0.565). There was difference between radiographically anticipated ideal femoral size and ideal femoral size values (Wilcoxon W 324.5; p 0.020). Anticipating the ideal femoral size can be made more precisely with computed tomography than radiographs in cadaver femora. Anticipating the ideal femoral component size by computed tomography may solve the problems in in-between sizes. Future total knee designs may be manufactured in more anatomic sizes.