LASER-ASSISTED FIBRIN CLOT SOLDERING OF HUMAN MENISCI

Fibrin mixtures have been used as a solder in conjunction with argon i on lasers to create strong tissue welds in several organ systems. An a nalogous method of meniscus repair could obviate the need for partial meniscectomy and its subsequent degenerative effects in a subset of me niscal tears. This study measured the in vitro tensile strength in 4 g roups of human menisci (1-mm x 2-mm x 5-mm sections): (1) bisected men isci repaired with fibrin clot mixture, (2) bisected menisci bonded by fibrin clot mixture and exposure to argon laser energy (energy densit y, 60 W/ cm(2)), (3) bisected menisci repaired with 2 interrupted sutu res, and (4) untreated meniscal controls. After irradiation with argon ion laser energy, the tensile strength of the laser-assisted fibrin c lot-bonded menisci increased 40-fold over that of nonirradiated fibrin clot-bonded menisci. Suture controls (0.515 +/- 0.221 MPa) had a high er tensile strength than the fibrin clot mixture and irradiated groups ; however, the suture controls had only 8.5% the strength of native me nisci (6.081 +/- 0.221 MPa). Laser-assisted fibrin clot soldering may allow the opposing edges of a meniscal tear to be held together with a biologic scaffold, possibly inducing reparative cell migration and pr oliferation.