Efficacy and safety of laser-assisted techniques in orthopedic surgery: a meta-analysis of randomized controlled trials

Abstract

In orthopedic surgery, laser-assisted procedures have shown great promise as adjuncts, with the potential to enhance patient outcomes, decrease tissue damage, and increase precision. However, a thorough evaluation of their safety and effectiveness is essential. The purpose of this meta-analysis is to thoroughly assess the data from randomized controlled trials (RCTs) to ascertain the possible dangers and clinical advantages of using laser-assisted techniques during orthopedic procedures. We conducted a comprehensive literature search across PubMed, Cochrane Library, Embase, and Web of Science, covering publications until April 2024. RCTs evaluating laser-assisted techniques in orthopedic surgery were included if they reported on operative time, blood loss, postoperative pain, functional outcomes, complication rates, or patient satisfaction. Data were extracted by two independent reviewers and analyzed using SPSS software. Methodological quality was assessed using the Cochrane Risk of Bias tool. Twenty-three RCTs, involving a total of 2,032 patients, met the inclusion criteria. Laser-assisted techniques significantly reduced operative time (MD - 15.32 min; 95% CI - 22.45 to - 8.19; p < 0.001) and postoperative pain (MD - 1.27; 95% CI - 1.91 to - 0.63; p < 0.001). Although the reduction in blood loss did not reach statistical significance (MD - 52.18 mL; 95% CI - 114.32 to 9.96; p = 0.10), the trend suggested potential benefits. Functional outcomes and patient satisfaction were significantly improved, while complication rates were comparable to conventional methods (RR 0.98; 95% CI 0.82 to 1.17; p = 0.84). Publication bias was assessed and found to be minimal. Significant decreases in operating time and postoperative pain, as well as enhanced patient satisfaction and functional results, are linked to laser-assisted orthopedic surgery procedures. The trend points to a possible benefit even though the decrease in blood loss was not statistically significant. These results demonstrate the advantages and safety of laser technology and justify its use in orthopedic surgery. To standardize procedures and improve these methods in various surgical settings, more study is required.

Keywords: Functional outcomes; Laser-assisted surgery; Meta-analysis; Operative time; Orthopedic surgery; Patient satisfaction; Postoperative pain; Randomized controlled trials.