Lu Y, Edwards R B, Cole B J, Markel M D
Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 53706-1102, USA.
Am J Sports Med. 2001 Jan-Feb;29(1):42-9.
The purpose of this study was to examine the in vitro effects of three radiofrequency energy devices (two bipolar devices and one monopolar device) for the performance of thermal chondroplasty. Thirty-two fresh bovine femoral osteochondral sections (approximately 3 x 4 x 5 cm) from eight cows were divided into four groups (three treatment patterns and one sham-operated group with eight specimens per group). The three treatment patterns consisted of 1) radiofrequency energy delivered by a mechanical jig at 1 mm/sec in a contact mode (50 g of pressure), 2) radiofrequency energy delivered by a mechanical jig at 1 mm/sec in a noncontact mode (1 mm between probe tip and articular cartilage surface), and 3) radiofrequency energy smoothing of abraded cartilage during arthroscopic visualization. Thermal smoothing of the abraded cartilage surface was accomplished with all three devices. Significant chondrocyte death, as determined by confocal laser microscopy and cell viability staining, was observed with each device. The bipolar radiofrequency systems penetrated 78% to 92% deeper than the monopolar system. The bipolar systems penetrated to the level of the subchondral bone in all osteochondral sections during arthroscopically guided paintbrush pattern treatment. Radiofrequency energy should not be used for thermal chondroplasty until further work can establish consistent methods for limiting the depth of chondrocyte death while still achieving a smooth articular for thermal chondroplasty until further work can establish consistent methods for limiting the depth of chondrocyte death while still achieving a smooth articular surface.
本研究的目的是检验三种射频能量设备（两种双极设备和一种单极设备）用于热软骨成形术的体外效果。从八头奶牛获取的32个新鲜牛股骨骨软骨切片（约3×4×5厘米）被分为四组（三种治疗模式和一个假手术组，每组八个标本）。三种治疗模式包括：1）通过机械夹具以1毫米/秒的速度在接触模式（50克压力）下输送射频能量；2）通过机械夹具以1毫米/秒的速度在非接触模式（探头尖端与关节软骨表面之间距离1毫米）下输送射频能量；3）在关节镜观察期间对磨损软骨进行射频能量平滑处理。所有三种设备均实现了对磨损软骨表面的热平滑处理。通过共聚焦激光显微镜和细胞活力染色确定，每种设备均观察到显著的软骨细胞死亡。双极射频系统比单极系统穿透深78%至92%。在关节镜引导的刷状模式治疗期间，双极系统在所有骨软骨切片中均穿透至软骨下骨水平。在能够建立一致的方法来限制软骨细胞死亡深度同时仍能实现光滑关节表面之前，不应将射频能量用于热软骨成形术。
