Laser-assisted fibrin clot soldering of human menisci : The laser in orthopaedic surgery

Fibrin mixtures have been used as a solder in conjunction with argon ion lasers to create strong tissue welds in several organ systems. An analogous method of meniscus repair could obviate the need for partial meniscectomy and its subsequent degenerative effects in a subset of meniscal tears. This study measured the in vitro tensile strength in 4 groups of human menisci (1-mm×2-mm×5-mm sections): (1) bisected menisci repaired with fibrin clot mixture, (2) bisected menisci bonded by fibrin clot mixture and exposure to argon laser energy (energy density, 60 W/cm 2 ), (3) bisected menisci repaired with 2 interrupted sutures, and (4) untreated meniscal controls. After irradiation with argon ion laser energy, the tensile strength of the laser-assisted fibrin clot-bonded menisci increased 40-fold over that of nonirradiated fibrin clotbonded menisci. Suture controls (0.515±0.221 MPa) had a higher tensile strength than the fibrin clot mixture and irradiated groups; however, the suture controls had only 8.5% the strength of native menisci (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 proliferation