A review of current concepts in radiofrequency chondroplasty

Abstract

Radiofrequency (RF) chondroplasty is a promising treatment of chondral defects. The purpose of this study is to summarize current literature reporting the use of radiofrequency energy as an alternative treatment to mechanical shaving in chondroplasty. This review depicts the basic understanding of RF energy in ablating cartilage while exploring the basic science, laboratory evidence and clinical effectiveness of this form of chondroplasty. Laboratory studies have indicated that RF energy decreases inflammatory markers in the cartilage as well as providing optimal results with smoothing of chondral clefts. There have been concerns of chondrolysis due to heat damage of chondrocytes; however, this is unsubstantiated in clinical studies. These clinical trials have highlighted that RF energy is a safe and efficacious method of chondroplasty when compared to the mechanical shaving technique.

Mechanical debridement versus radiofrequency in knee chondroplasty with concomitant medial meniscectomy: 10-year results from a randomized controlled study

“…MD aims to produce stable and nearly smooth articular cartilage surfaces, remove loose flakes, and potentially stimulate the regeneration of articular cartilage. The most important disadvantages of MD are the inability to control ablation within the deep layer and the removal of intact tissue surrounding the lesion [9, 23]. The application of thermal energy is sufficient to smooth the articular cartilage surface within deep lesions [2].…”

The use of radiofrequency in equine orthopedic surgery

“…24 Additionally, it is thought that the unavoidable removal of excessive healthy cartilage can lead to progression of the lesion and a thinner cartilage surface, which in some cases results in dissatisfaction with motorized resection. 25 RFE has several distinct advantages over traditional shavers, specifically the property of allowing the user to rapidly smooth and contour the fibrillated cartilage and its margins without leaving surface irregularities or unstable borders. 26 The superior mechanical stability of the RFE-treated cartilage defect has been reported to provide resistance to continued fibrillation and lesion progression.…”

Use of a Novel Variable Power Radiofrequency Ablation System Specific for Knee Chondroplasty: Surgical Experience and Two-Year Patient Results

“…An arthroscopic shaver is often used to mechanically debride the lesion. However, this has been associated with inadvertent removal of adjacent healthy tissue and resultant lesion progression [12,13]. Radiofrequency (RF) ablation is an alternative that has recently gained in popularity for chondroplasty in arthroscopic knee surgery.…”