gms | German Medical Science

Objectives/Interrogation: Over the last years treatment of cartilage degeneration with radiofrequency energy (RFE) has been still a controversy. Many experimental studies have been shown, that using RFE can lead to a severe damage to chondrocytes, which may be critical in the wrist and MCP-Joints, where the cartilage layer is extremely thin compared to other joints. The goal and the positive effect using RFE instead of a mechanical debriding is the so called "sealing effect" of the cartilage layer, which has been proved histological and morphological to stabilize the damaged cartilage.

Methods: This experiment was conducted on fresh ostechondral sections from the tibia plateau of slaughtered 6 month old pigs, where the thickness oft he cartilage is similar to the wrist. An area of 1 cm2 was first treated with emery paper to simulate the chondromalacic cartilage. Than the treatment with RFE followed in 6 different pattern. The Osteochondral section where post processed with Live/Dead staining, caspase staining and a quantitative analysis by confocal laser scanning microscopy (CLSM). For quantitative characterization of the surfaces various roughness parameters were measured using the Olympus LEXT OLS 4000 3D CLSM. To describe the roughness the Root-Mean-Square parameter Sq was registrated.

Results and Conclusions: A smoothing effect of the cartilage surface was detectable. The smoothing effect was depended of the number passes of the RFE over the cartilage surface. The better the smoothing effect was, it was unfortunately correlated with an increasing rate of death chondrocytes up to 99%.

Using RFE treatment in arthroscopy in small joints like the wrist or MCP joints should be only used under great care, especially when a chondroplasty is performed. There is h likely high chance to destroy the joint.