Optimization of high-frequency electrosurgery of the meniscus

Abstract

In an in vitro study of the sheep's meniscus, the possibilities to reduce the thermal tissue necrosis caused by high-frequency electrosurgery of the meniscus were studied. Under standardized conditions, machine-made sections through the meniscus were cut using electrodes of various thicknesses and different settings of the electric generator. The thermal tissue necrosis near the cut through the meniscus was determined using light microscopy and image analysis on the specimen stained according to Masson-Goldner. With a constant voltage of 250 V tissue necrosis was significantly less for electrodes of a diameter of 0.5 mm than for 1.5-mm electrodes (187.3 microns as compared with 368.0 microns). For electrosections carried out using a commercially available electrode with a low voltage of 250 V as well as with a power-controlled generator, tissue necrosis was also significantly less than with a constant high voltage of 395 V (181.4 microns and 210.2 microns as compared with 325.0 microns). Thus, an effective reduction of thermal tissue necrosis in arthroscopic partial meniscectomy is possible when thin electrodes and power-controlled generators are used.

Radiofrequency Thermal Effects on the Human Meniscus: An in Vitro Study of Systems with Monopolar and Bipolar Electrodes

“…Previous experiments have shown the average thermal change produced by lasers or electrosurgical devices on the meniscus to range from a depth of 24 to 1980 m. 4,7,10,[12][13][14] Vangsness et al 14 measured thermal change in the human meniscus with several laser systems and found depths of change ranging from 96 (excimer) to 1980 (carbon dioxide) m. Sherk et al, 13 in a report on laser-induced thermal change, found a range of 24 (excimer) to 378 (neodynium:yttrium-aluminum-garnet) m. The depth of thermal change produced by the electrosurgical radiofrequency devices in this series was comparable with reported values in the literature on other lasers or electrosurgical devices. Recent work has demonstrated time-zero thermal change in the human meniscus to average around 550 m with a bipolar radiofrequency energy device.…”

Grundlagen radiochirurgischer Systeme und ihre Anwendungen in der Arthroskopie

“…zu ersetzen. In verschiedenen Studien wurden diese Methoden untersucht und miteinander verglichen [30,31].…”