DELAYED ARTICULAR-CARTILAGE SLOUGH - 2 CASES RESULTING FROM HOLMIUM-YAG LASER DAMAGE TO NORMAL ARTICULAR-CARTILAGE AND A REVIEW OF THE LITERATURE

We present two cases referred from other physicians with chondral dama ge and cartilage slough secondary to use of the holmium:YAG laser duri ng knee arthroscopy, The first patient had a partial lateral meniscect omy, which was done with a 20-W Ho:YAG laser. The patient never fully recovered and underwent a second arthroscopy that revealed full-thickn ess cartilage defects of the lateral femoral condyle. The second patie nt had debridement of Outerbridge grade In changes of the lateral tibi al plateau and patella, as well as a partial lateral meniscectomy usin g a Ho:YAG laser. The patient developed recurrent symptoms, and when a second arthroscopy was performed, new degenerative changes to the lat eral femoral condyle were noted with large areas of cartilage loss. A careful look needs to be taken at the limited use of lasers until furt her randomized prospective studies are carried out comparing patient o utcomes, cost, and long-term complications.