ABSTRACTThis study evaluated the potential of repairing a tear in the avascular region of the meniscus using Nd:YAG laser and fibrin glue containing india ink as a chromophore. Experimentally created tears were made in the avascular area of the posterior horn of the medial meniscus in 26 New Zealand White rabbits. They were divided into 4 groups: controls were closed after exposure and creation of the tear, tears treated with laser only, tears treated with fibrin glue only, and tears treated with both laser and Fibrin glue. Twelve rabbits were sacrificed at 4 weeks and 12 at 12 weeks. Laser parameters were 1.0 W (3 mm spot; 70–100 J). At sacrifice, the meniscus was fixed and sectioned. The sections were examined with H&E, Trichrome, and Toluidine Blue stains. The meniscal slides were graded on a scale of 0–3 for areas of necrosis, cloning, matrix production, and overall degeneration. Four contralateral knees were treated with both laser and fibrin glue at the time of sacrifice and considered time 0 specimens. Histologically the meniscal cells surrounding the tear remained viable after laser treatment and the fibrin remained interposed within the tear. At 4 weeks, cloning and matrix production averaged 2.7/3.0 for the fibrin group and 2.3/3.0 for the laser and fibrin group. In contrast, the laser only and control groups were graded less than 1.0/3.0 for cloning and matrix production. This proteinacious matrix that was observed in both fibrin groups was deposited within the tear. This effect was not apparent in the 12 week group. Necrosis and degeneration were negligible in all of the 4 week groups. This study supports the concept that fibrin can be used to stimulate a cellular response in the avascular region of the meniscus. Using fibrin glue with india ink as a chromophore, the Nd:YAG laser was used successfully to coagulate and stabilize the fibrin glue in the tear without causing thermal dam
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