What are the current indications for use of radiofrequency devices in Hip arthroscopy? A systematic review: Table I

Abstract

The role of radiofrequency energy (RFE) devices has been minimally studied in hip arthroscopy. The purpose of this study was to determine the role of RFE devices in hip arthroscopy through a systematic review of the literature. We searched the PubMed database using the following Medical Subject Heading terms: hip arthroscopy, hip radiofrequency, thermal capsulorrhaphy, thermal chondroplasty and radiofrequency debridement. Two authors independently reviewed the literature and included articles based on predetermined inclusion criteria. We excluded review, technique and experimental articles. After title and abstract review, we selected 293 articles for full-text review. Ten articles met the inclusion and exclusion criteria. For the included articles, a total of 305 hips underwent arthroscopy with concomitant RFE treatment at a mean age of 25.7 years. Eight articles presented patient-reported outcome (PRO) instruments, one study did not report an outcome instrument but utilized an evaluation of postoperative range of motion (ROM) and 1 year magnetic resonance image (MRI) and computed tomography (CT) imaging. The remaining article measured only the ROM pre- and postoperatively. Only one of the articles reviewed reported complications. Current evidence on the safety and indications for use of RFE devices in hip arthroscopy is insufficient. The literature shows mixed results regarding its use in hip arthroscopy. Although the use of thermal energy is not without risk, if used judiciously and appropriate precautions are taken to avoid damage to adjacent tissues, those devices can be useful for the treatment of certain intra-articular hip pathologies arthroscopically.

A Systematic Summary of Systematic Reviews on the Topic of Hip Arthroscopic Surgery

“…4,65 Moreover, the risk-benefit ratio of hip arthroscopic radiofrequency device use in soft tissue handling, capsular management, synovial inflammation, and chondral injuries remains unknown. 82…”

Overview of Tips in Overcoming Learning Curve in Uniportal and Biportal Endoscopic Spine Surgery

“…If energy is too high it can cause a phenomenon which is similar to Electric Convulsive Therapy (ECT) which can cause patient to be in a stupor state or worst scenario of cardiac complications such as asystole 45) . We do not recommend use of arthroscopic setting use in knee and shoulder to be use in spine 51) . While an energy setting which is too close to low energy radiofrequency ablation may not be efficient in soft tissue dissection in a layer dorsal to ligamentum flavum.…”

Upper limb and lower limb radiofrequency treatments in orthopaedics

“…Although adverse events from RF are unusual, potential complications can include infection, bleeding, numbness or dysesthesia, increased pain at the procedural site, deafferentation effect, and Charcot joint neuropathy. Although there is a risk of damaging non-targeted neural tissue and other structures, this can be mitigated by performing the technique under imaging guidance (fluoroscopy, ultrasonography, and computed tomography) ( 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ).…”