Arthroscopic Evaluation of Radiofrequency Chondroplasty of the Knee

Abstract

Only 3 of 25 lesions demonstrated progression. More than 50% showed partial or complete filling of the defect. Bipolar radiofrequency chondroplasty is an effective way to treat partial-thickness cartilage lesions; however, long-term effects of this treatment on cartilage remain unknown.

Focal Articular Cartilage Defect Treated by Percutaneous Radiofrequency Ablation

“…This supposition is also supported by research that shows that arthritic articular cartilage metabolic activity is more sensitive to thermal energy (11). Previously RF-treated chondral defects exhibit stable repair tissue, which appears to be fibrocartilagelike in texture and appearance (2,12). The potential sources for cell migration into the chondral defects that fill in with tissue are speculative.…”

“…A common treatment for these lesions is to debride and smooth the damaged articular cartilage surface with a mechanical shaver to achieve a stable surface and remove any loose flaps. In the last few years, the use of RF-generating energy devices in arthroscopic surgery has been advocated (2)(3)(4). The RF probe delivers a controlled amount of energy resulting in precise tissue ablation, whereas mechanical shavers may not allow similar precise targeting of chondromalacic fronds or fibrillations (3).…”

“…The RF probe delivers a controlled amount of energy resulting in precise tissue ablation, whereas mechanical shavers may not allow similar precise targeting of chondromalacic fronds or fibrillations (3). Therefore, thermal energy is believed to provide a smoother surface, with improved surgical access to seal the damaged articular cartilage, which may decrease the tendency for further delamination and reduce the release of proteoglycan and collagen fragments that promote intraarticular inflammation (2)(3)(4). Heat application first causes the loss of fibrillation and later shrinkage of the surrounding cartilage.…”

“…The poor healing ability of articular cartilage may predispose the surrounding cartilage to progressive damage, leading to enlargement of the defect and release of intraarticular debris, which result in mechanical or inflammatory symptoms (2). Traditionally, unstable cartilage lesions are treated arthroscopically, using mechanical instrumentation.…”

“…Traditionally, unstable cartilage lesions are treated arthroscopically, using mechanical instrumentation. In the last few years, the use of radiofrequency (RF)-generating energy devices in arthroscopic surgery has been advocated (2)(3)(4). On the other hand, percutaneous RF ablation, initially described as a primary treatment for osteoid osteoma in 1992, and now considered as its treatment of choice, is a minimally invasive procedure with outcomes comparable to surgery but with fewer complications and faster recovery time (5)(6)(7)(8).…”