Arthroscopic evaluation of radiofrequency chondroplasty of the knee (SS-73)

Abstract

Limited information is available on the effect of thermal radiofrequency (RF)-chondroplasty on articular cartilage. The published data offers contradictory results. This study utilized second look arthroscopy to evaluate the healing of partial-thickness chondral defects previously treated with RF-chondroplasty. Based on reported confocal laser microscopy data, we hypothesized that partial-thickness articular cartilage lesions treated with RF-chondroplasty would show progressive deterioration. One hundred ninety three patients underwent bipolar RF-chondroplasty by the senior author from 06/01/99 to 07/01/02. Fifteen (30 RF-chondroplasty treated defects) underwent repeat arthroscopy for various reasons. The average time from chondroplasty to repeat arthroscopy was 13 months (range 2–32). The location, size, grade, and stability of lesions at the original and subsequent surgery were recorded. Measurements were obtained from arthroscopic pictures and data recorded at the time of surgery. The average patient age was 39.4 years (range 27–52). The average size of the lesion was 160mm2 (range 6–625). Five lesions (16.7%) demonstrated unstable borders and progressive damage to surrounding cartilage. Eight lesions (26.7%) preserved stable borders and showed no progressive damage. Nine lesions (30%) demonstrated partial stable cartilage caps and eight lesions (26.7%) demonstrated complete stable cartilage caps covering previous defects. Lesions in the tibiofemoral compartments demonstrated better healing ability than patellofemoral lesions (P < .05). Contradictory to our hypothesis, 25 of the 30 lesions in this study demonstrated no deterioration of the cartilage defects and no damage to surrounding cartilage. We conclude that RF-chondroplasty offers a good chance of stabilizing and potentially healing partial cartilage lesions.