The Arthroscopic Application of Radiofrequency in Treatment of Articular Cartilage Lesions

Abstract

Articular cartilage lesion is a common disease to be treated by arthroscopic surgery. It will eventually progress to osteoarthritis without proper management, which can affect patients’ work and daily life seriously. Although mechanical debridement and laser have been used clinically for its treatment, due to their respective drawbacks, radiofrequency has drawn increasing attention from clinicians as a new technique with more advantages. However, the safety and efficacy of radiofrequency have also been questioned. In this article, the scope of application of radiofrequency was reviewed following an introduction of its development history and mechanism, and the methods to ensure the safety and effectiveness of radiofrequency through power and temperature control were summarized.

Therapie chondraler und osteochondraler Läsionen der Hüfte

“…Chondroplasty should not be performed on advanced arthritis that requires total hip arthroscopy and should be preferentially carried out on patients with pre-existing OA [ 69 ]. It is also important to avoid using radiofrequency ablation devices around chondral tissue, as they can damage chondrocytes [ 70 ]. Chondroplasty is the most commonly performed procedure in hip arthroscopy, accounting for 49.3% of cases [ 68 ].…”

The use of radiofrequency in equine orthopedic surgery

“…26 The superior mechanical stability of the RFE-treated cartilage defect has been reported to provide resistance to continued fibrillation and lesion progression. 27 Additionally, the bipolar plasma gas layer anneals and stabilizes the cartilage surface, reducing the permeability of the matrix and decreasing the release of inflammatory mediators. 28,29 Despite these well-established benefits of RFE, the concern of detrimental chondrocyte damage remains a barrier to its use in clinical cases of cartilage debridement.…”

“…30 RFE use in humans is largely limited to arthroscopy of the knee joint or soft tissue procedures involving debridement, resection, and techniques for thermal joint capsule shrinkage. 27 While many clinical studies prove the effectiveness and safety of RF, there is limited evaluation of the long-term biochemical changes to the cartilage of treated joints, which is consequently an area requiring further investigation before RFE can be recommended. Additionally, while the importance of exposure time, probe settings, and technique on the temperature profile and resultant thermal injury has been highlighted, conclusive guidelines ensuring safe use have not been determined.…”

Arthroscopic Management of Joint Problems in the Sport Horse

“…After an optimistic start of this technique, its deleterious effects on cartilage were demonstrated [40], but more recently the development of radiofrequency probes with greater control of thermal energy seems to have given rise to this technique, which is used to debride the articular surface in cases of joint fibrillation [41]. Currently, the author suggests caution when using thermal chondroplasty.…”