Assessment of cellular, biochemical, and histologic effects of bipolar radiofrequency treatment of canine articular cartilage

Abstract

In this study, bipolar radiofrequency treatment had detrimental effects on normal articular cartilage cells and extracellular matrix with probable long-term clinical consequences. The usefulness of radiofrequency for treatment of osteoarthritic articular cartilage requires further investigation.

Changes to articular cartilage following remote application of radiofrequency energy and with or without Cosequin therapy

“…This chondrocyte death was evident even though the RF energy was applied to the soft tissues in the joint and not directly to the cartilage. Our findings are consistent with other reports in which significant loss of chondrocyte viability was noted immediately after direct application of RF energy to the cartilage (2)(3)(4)(5)(6)12).…”

“…However, to the author's knowledge, the current literature does not contain documentation of the changes that occur in the articular cartilage following the remote treatment of the soft tissues in the joint with RF energy. Lu et al recently reported the fluid temperatures created in the joint during capsular shrinkage with RF energy (28), and Cook et al reported that cartilage explants incubated in culture media greater than 45ºC lead to chondrocyte death (6). However, the biological response of chondrocytes subjected to indirect RF energy is still unknown.…”

“…Numerous research projects have documented the changes in the articular cartilage resulting from the use of RF energy to treat cartilage defects (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13). However, most of this research has focused on the acute effects of monopolar (mRF) or bipolar (bRF) RF energy when applied directly to the cartilage surface (contact treatment).…”

“…Recently, Cook et al used in vitro techniques to study the cellular and biochemical changes in articular cartilage treated with RF energy (6). It was noted that the glycosaminoglycan (GAG) content was largely unchanged, type-II collagen was significantly decreased, and that matrix metalloproteinase (MMP)-13 was significantly increased in the treated tissue.…”

Stellenwert des Débridements bei der Behandlung fokaler (Grad II – III) Knorpelschäden des Kniegelenks. Systematische Literaturübersicht und Empfehlungen der AG Geweberegeneration (DGOU)

“…Die optisch imponierende "Versiegelung" basiert auf einer Denaturierung der Kollagenfasern an der Oberfläche durch erhöhte Temperatur. Diese Strukturveränderung kann zwar die Permeabilität der Matrix reduzieren, dies bewirkt jedoch keine Retention der Proteoglykane im Knorpelgewebe [41,55]. Dagegen geht grundsätzlich der Zellverlust im Bereich der Grenzfläche durch Apoptose/Nekrose sogar mit einem erheblichen Proteoglykanverlust einher [56].…”