The Use of Radiofrequency Energy for Arthroscopic Chondroplasty in the Knee

Comparison of Acute Histologic and Biomechanical Effects of Radiofrequency Ablation and Cryoablation on Periarticular Structures in a Swine Model

“…RF chondroplasty has been shown to slow degradation and improve symptoms by smoothing the abnormal articular surface and decreasing permeability (16). Histologic analysis has revealed that the collagen triple helix is denatured during low-heat temperatures (401C-701C) but reforms bonds in a less organized manner after cooling; at higher temperatures (4 1001C), the collagen macromolecule is completely destroyed (16). In this procedure, an RF wand is briefly passed over the target lesion to heat the superficial aspect of the cartilage to minimize conduction of heat energy through the entire cartilage thickness.…”

“…RF energy is a commonly used tool for performing chondroplasty on partial-thickness cartilage defects, which can cause crepitus and progressive pain (16). RF chondroplasty has been shown to slow degradation and improve symptoms by smoothing the abnormal articular surface and decreasing permeability (16).…”

Instrumentation

“…RF devices used in a cutting mode, at the lowest settings that will still cut plica, ligament, menisci, or masses, seem to be safe if the probe is directed away from cartilage and does not dwell on bone (Polousky et al, 2000;Lee et al, 2002). A recent review of RF chondroplasty was less critical, although still cautious, and presented three units as potentially preferable to others (Kosy et al, 2011). However, RF devices used for thermal chondroplasty at recommended settings penetrate to the subchondral bone and cause chondrocyte death (Lu et al, 2000(Lu et al, , 2001.…”

A review of current concepts in radiofrequency chondroplasty

“…Chondral defects are seen in 60% of all knee arthroscopy procedures with injury to articular cartilage causing progressive and permanent damage . These defects are described in terms of grading systems, such as the International Cartilage Research Society (ICRS) grading system .…”

“…Discontentment with traditional treatments to chondral lesions including mechanical shaving has led researchers to experiment with other means of smoothing cartilage . One experimental treatment that was considered as a possible method was the utilization of lasers; however, it was soon recognized that these caused major damage including osteonecrosis to underlying bone as well as being difficult to manoeuvre the probe . This led to research into the use of RF energy as an effective treatment in chondroplasty.…”