A breakthrough in laser bone surgery is raising expectations for contact-free cutting in orthopedic procedures. Researchers at the University of Basel reported deeper, faster bone ablation using a redesigned laser-beam profile. They said the approach improves efficiency without simply increasing laser power.
Lasers can cut precisely and without mechanical pressure, which may reduce the formation of microcracks in bone. That could matter for specialized cuts and for fitting joint implants, including custom 3D-printed implants. Until now, bone cutting depth has limited broader surgical use.
Why Bone Lasers Have Lagged Behind Saws And Drills
Mechanical tools still dominate bone surgery because they cut quickly and predictably. Lasers have been more common in soft tissue, where cutting speeds are less restrictive. In bone, surgeons need depth and speed with low thermal damage.
Previous laser osteotomy systems often reached only 2 to 3 centimeters in depth, the researchers said. That depth is too shallow for many joint implant workflows. One key constraint is the distribution of energy within the laser beam.
Simply increasing laser energy is not an acceptable solution, the researchers said. Higher energy can char bone and potentially impair healing. The team instead changed the beam profile to deliver energy more evenly.
Top Hat Beam Profile Delivers Deeper, Cleaner Ablation
The study compared two Er:YAG laser intensity profiles under the same operating conditions. The traditional profile is Gaussian, with the strongest intensity at the center. The new “top hat” profile spreads energy more evenly, then drops sharply at the edge.
Using bovine femur cortical bone and optimized water–air cooling, the top hat profile reached 44.51 millimeters of depth. The Gaussian profile reached 26.51 millimeters under the same setup. The authors reported a twofold depth gain over prior optimized Er:YAG reports.
Material removal rates also improved, according to the paper. The top-hat setup achieved an average removal rate of 0.42 mm³/s in the reported configuration. The Gaussian setup reached 0.24 mm³/s in that same comparison.
The team also reported higher removal rates in dry surface ablation, but with more carbonization. In that dry condition, the top hat profile reached 1.58 mm³/s ± 0.04 mm³/s, the paper said. That tradeoff underlines why cooling and debris management remain central to clinical feasibility.
Commercial Stakes For Medtech And Data-Driven Surgery
The researchers said a major efficiency issue is energy loss to the cut walls at greater depths. With conventional profiles, the cut walls absorb energy that should reach the cutting front. The top hat profile changes that balance, helping more energy reach the bottom of the cut.
Even with the improvement, lasers remain far slower than metal blades in practice. The researchers said their laser removes about 0.4 cubic millimeters per second. They said a mechanical saw removes about 11 cubic millimeters per second, more than 20 times as much. That gap is critical for operating-room economics and throughput.
The study framed the depth milestone as relevant to knee replacement geometry. The authors said that performance is approaching the planar cut dimensions required for distal femoral resurfacing in total knee arthroplasty. They also reported minimal compositional change after ablation, supporting claims of limited thermal damage.
The work sits within the Basel-led “Miracle” project, funded by the Werner Siemens Foundation, the researchers said. They also linked it to an Innosuisse “Laser-Blade” collaboration with medical technology company Smith+Nephew. That connection suggests a pathway from lab validation toward device development and regulatory planning.
The researchers said the next step is to adapt the system to the body’s complexity and to protect nearby tissue. For investors, the near-term signal is technical de-risking, not a product launch. The longer-term question is whether speed, workflow integration, and safety can match hospital requirements.
