Radiofrequency Chondroplasty May Not Have a Long-Lasting Effect in the Treatment of Concomitant Grade II Patellar Cartilage Defects in Humans

Abstract

The effect of radiofrequency chondroplasty on cartilage tissue is not well studied. This prospective pilot study investigates the effect of radiofrequency chondroplasty on International Cartilage Repair Society (ICRS) grade II patellar cartilage defects using high-resolution magnetic resonance imaging (MRI) with T2 mapping. Six consecutive patients were treated for ICRS grade II patellar cartilage defects using radiofrequency chondroplasty. Before surgery and at defined follow-ups (2 weeks, 4 and 12 months) a high-resolution morphological 3 Tesla MRI with quantitative T2 mapping was performed. At baseline MRI, global T2 values of cartilage defects were increased (46.8 ms ± 9.7) compared to healthy cartilage (35.2 ms ± 4.5) in the same knee which served as reference. Two weeks after treatment, global T2 values (39.2 ms ± 7.7) of the defect areas decreased. However, global T2 values of the defect areas increased beyond the preoperative levels at 4 months (47.4 ms ± 3.1) and 12 months (51.5 ms ± 5.9), respectively. Zonal T2 mapping revealed that the predominant changes in T2 values occurred at the superficial cartilage layer. T2 mapping appears to be an ideal method to monitor cartilage degeneration after chondroplasty. Based on the small sample size of this pilot study, radiofrequency chondroplasty may cause cartilage damage and may not have a long-lasting effect in the treatment of grade II patellar cartilage defects. In five out of six patients, postoperative cartilage damage was observed on quantitative MRI. This study was therefore terminated before completion. We recommend only addressing the pathology which indicated arthroscopy and leaving concomitant cartilage lesions untreated.

Introducing a Novel Combined Acetabuloplasty and Chondroplasty Technique for the Treatment of Developmental Dysplasia of the Hip

“…Furthermore, traditional chondroplasty is a technique that involves the debridement of intraarticular soft tissues, including cartilage and labral defects [16]. This technique has been widely cited in the knee and hip literature, particularly in studies investigating the sequelae of osteoarthritis, femoroacetabular impingement, and Legg-Calvè-Perthes disease [17][18][19][20][21]. In all cases, chondroplasty was performed arthroscopically with a mechanical shaver or radiofrequency energy to reduce joint friction caused by chondral labral tissue defects.…”

The Arthroscopic Application of Radiofrequency in Treatment of Articular Cartilage Lesions

“…This includes the long-term follow-up study conducted by Spahn et al for 10 years. Recently, Koller et al put forward an opposite point of view ( Koller et al, 2020 ). They planned to use the magnetic resonance imaging T2 Mapping technique to quantitatively evaluate the efficacy of radiofrequency chondroplasty in patients with Outerbridge Grade Ⅱ lesions of the patella 1 year after surgery.…”