Comparison Between 2 Types of Radiofrequency Ablation Systems in Arthroscopic Rotator Cuff Repair: A Randomized Controlled Trial

Abstract

Background: Radiofrequency ablation is commonly used in arthroscopic rotator cuff repair (RCR). New technology devices incorporating a plasma bubble may generate lower intra-articular temperatures and be more efficient. Purpose: To compare a plasma ablation device with a standard ablation device in arthroscopic RCR to determine which system is superior in terms of intra-articular heat generation and diathermy efficiency. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: This was a single-center randomized controlled trial. The inclusion criteria were adult patients undergoing primary RCR. Patients were randomized preoperatively to the standard ablation group (n = 20) or plasma ablation group (n = 20). A thermometer was inserted into the shoulder joint during surgery, and the temperature, surgery, and diathermy times of radiofrequency ablation were measured continually. Results: No significant differences were found between the standard ablation group and plasma ablation group for maximum temperature (38.20°C and 39.38°C, respectively; P = .433), mean temperature (31.66°C and 30.64°C, respectively; P = .757), minimum temperature (21.83°C and 23.45°C, respectively; P = .584), and baseline temperature (28.49°C and 29.94°C, respectively; P = .379). Similarly, no significant differences were found for surgery time (74 and 75 minutes, respectively; P = .866) and diathermy time (10 minutes for both; P = .678). Seven patients registered transient high temperatures greater than 45°C. Conclusion: There was no difference between plasma ablation and standard ablation in terms of intra-articular temperature in the joint and diathermy efficiency. Transient high intra-articular temperatures occurred in both groups. Registration: ACTRN1261300056970 (Australian New Zealand Clinical Trials Registry).

Experimental and mathematically modelled temperature characteristics of human knee joint meniscus during radiofrequency resection

“…Tissue temperature during diathermy using a bipolar arthroscopic RF ablator ranged from 21.8°C to 39.4°C [32]. According to the user manual, the operating temperature for this electrode type ranges from 10°C to 40°C [7].…”

Intra-articular temperature monitoring during radiofrequency ablation in ex-vivo bovine hip joints via Fiber Bragg grating sensors

“…Faruque et al in their randomized control trial compared intra-articular temperature profile in standard ablation versus plasma ablation radiofrequency tools for rotator cuff repair. 17.5% of their patients showed temperatures above 45 °C but no significant variations where observed between standard and plasma radiofrequency devices [ 10 ].…”

“…Currently, some studies have tried to assess the variations in joint temperature during arthroscopic procedures on the shoulder and knee, both in human and animal models [ 2 , 7 , 10 , 23 , 24 ]. However, there is still a lack of evidence determining variations in joint and tissue temperature during radiofrequency ablation treatments in the hip joint.…”

Use of a larger surface area tip on bipolar radiofrequency wands in hip arthroscopy is associated with significantly lower traction and total surgery times

“…For example, traction time, traction force, perineal post modifications, postless techniques, fluid inflow rate and fluid pressure have all been studied in attempts to decrease hip arthroscopy complications [ 7–11 ]. One prior study evaluated two different types of radiofrequency ablation wands (plasma ablation versus standard ablation) during rotator cuff repair surgery and reported no difference in diathermy efficiency [ 19 ]. Both wands used in this study ablate tissue via a chemical process at the instrument tip, not a thermal process.…”