Abstract
IntroductionAlthough stabilisation of knee cartilage lesions (chondroplasty) may be performed with an arthroscopic shaver, more recently, radiofrequency (RF) ablation has gained in popularity. However, their remain some concerns about the avoidance of thermal injury, chondrolysis, and osteonecrosis with the use of RF devices.MethodsWe reviewed the outcomes of 85 knee chondroplasties performed with a new RF ablation wand designed for knee chondroplasty. Lesion details and Chondropaenia Severity Score (CSS) were recorded for each patient. We evaluated the occurrence of adverse outcomes, post-operative complications, and the need for further surgery. Post-operative outcomes scores (Oxford Knee Score [OKS], Knee injury and Osteoarthritis Outcome Score [KOOS], and International Knee Documentation Committee [IKDC] subjective knee outcome) were recorded at a minimum of one-year follow-up.ResultsAt the final mean follow-up of 27.5 months (range: 12-46.6 months), 12 (14%) knees had undergone or were listed for further surgery. Four patients had corticosteroid injections for ongoing pain at a median 7.5 months (range: 5-20 months) post-operatively. There were no observed re-operations considered to be caused by complications related to thermal injury. Of the six patients listed for or undergoing knee arthroplasty, five (83%) had grade 4 lesions found at the arthroscopic chondroplasty. A negative correlation was noted between CCS, and post-operative IKDC subjective score (R=-0.35), KOOS Sports (R=-0.39), and KOOS QoL (R=-0.36).ConclusionsWe found that RF chondroplasty appeared safe, and there were no concerns with regard to thermal injury. Functional outcome appeared to be related to the quality of chondral and meniscal tissue throughout all knee compartments, with better results for isolated grade 2 and 3 cartilage lesions.
Highlights
Stabilisation of knee cartilage lesions may be performed with an arthroscopic shaver, more recently, radiofrequency (RF) ablation has gained in popularity
A negative correlation was noted between CCS, and post-operative International Knee Documentation Committee (IKDC) subjective score (R=-0.35), Knee injury and Osteoarthritis Outcome Score (KOOS) Sports (R=-0.39), and KOOS QoL (R=-0.36)
We found that RF chondroplasty appeared safe, and there were no concerns with regard to thermal injury
Summary
We reviewed the outcomes of 85 knee chondroplasties performed with a new RF ablation wand designed for knee chondroplasty. We evaluated the occurrence of adverse outcomes, post-operative complications, and the need for further surgery. Inclusion criteria were all patients undergoing knee arthroscopic chondroplasty with or without treatment of a meniscal lesion or synovectomy. Patients with a chondral lesion stabilised using RF chondroplasty and further treated with an additional cartilage procedure, such as microfracture or autologous matrix-induced chondrogenesis, were included. We used the electronic patient record (Bluespier, Droitwich, Worcestershire, UK) to review the operative notes and clinic letters to retrieve clinical information, the types of pathology treated, and whether any intra-operative complications were reported. Patient demographic data (age, sex, side of surgery), operative data (location, size, and grade of chondral of lesions), meniscal pathology, and treatment were recorded. During the study period, the operating surgeons were asked to record any intra-operative adverse event
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