Amiel David, Ball Scott T, Tasto James P
Department of Orthopaedics, Connective Tissue Biochemistry, University of California San Diego, San Diego, La Jolla, California 92093-0630, USA.
Arthroscopy. 2004 May;20(5):503-10. doi: 10.1016/j.arthro.2004.03.018.
Some controversy exists regarding the effects of radiofrequency (RF) probes on articular cartilage. To further elucidate these effects, we examined the chondrocyte viability and metabolic activity after treatment of fresh bovine articular cartilage with bipolar RF probes.
In vitro assessment.
Three fresh bovine knees served as a baseline control for chondrocyte viability, yielding 6 samples (1 from each medial femoral condyle and 1 from each lateral femoral condyle). After the baseline expected chondrocyte viability was determined, 3 additional bovine knees served as the experimental specimens for the study. Under sterile conditions, 2 different bipolar RF probes were used to treat the articular surface in a light contact mode, moving at a linear rate of 3 to 4 mm/s to provide tissue debridement. Full-thickness articular cartilage was then harvested from each of the treatment areas. Six samples per probe were then assessed for chondrocyte viability using fluorescent double-staining followed by confocal microscopy; 6 samples per probe were assessed for metabolic activity using an 35SO4 incorporation assay; and 12 additional untreated samples were obtained to serve as controls for viability (n = 6) and metabolic activity (n = 6).
The depth of chondrocyte death (mean +/- standard deviation) was 109.4 +/- 22.1 microm after treatment with the ACD-50 probe, and was 172.3 +/- 34.3 microm after treatment with the 2.5-mm/90 degrees probe. The 35SO4 uptake (mean +/- standard deviation) was 2584 +/- 1388 cpm/mg dry cartilage for the ACD-50 probe and 1995 +/- 852 cpm/mg of dry cartilage for the 2.5-mm/90 degrees probe. The 35SO4 uptake for the control was 2647 +/- 1380 cpm/mg dry cartilage.
The 2 probes tested created a well-controlled debridement with smooth edges and a defined margin of chondrocyte death that extended approximately 100 to 200 microm deep to the treatment area. There does not appear to be a significant effect on the metabolic activity of the chondrocytes adjacent to the treatment zone, but with the small sample size we lacked sufficient statistical power to definitively determine these effects.
The 2 bipolar radiofrequency probes tested created a well-controlled debridement in normal articular cartilage with smooth edges and a defined margin of chondrocyte death that extended approximately 100 to 200 microm into the treatment area.
关于射频(RF)探头对关节软骨的影响存在一些争议。为了进一步阐明这些影响,我们在用双极RF探头处理新鲜牛关节软骨后,检测了软骨细胞的活力和代谢活性。
体外评估。
取三个新鲜牛膝关节作为软骨细胞活力的基线对照,得到6个样本(每个内侧股骨髁1个,每个外侧股骨髁1个)。在确定基线预期软骨细胞活力后,另外三个牛膝关节作为研究的实验标本。在无菌条件下,使用两种不同的双极RF探头以轻接触模式处理关节表面,以3至4毫米/秒的线性速度移动以进行组织清创。然后从每个治疗区域采集全层关节软骨。然后使用荧光双重染色和共聚焦显微镜对每个探头的6个样本进行软骨细胞活力评估;使用35SO4掺入试验对每个探头的6个样本进行代谢活性评估;另外获取12个未处理的样本作为活力(n = 6)和代谢活性(n = 6)的对照。
用ACD - 50探头处理后软骨细胞死亡深度(平均值±标准差)为109.4±22.1微米,用2.5毫米/90度探头处理后为172.3±34.3微米。ACD - 50探头的35SO4摄取量(平均值±标准差)为2584±1388 cpm/毫克干软骨,2.5毫米/90度探头为1995±...852 cpm/毫克干软骨。对照的35SO4摄取量为2647±1380 cpm/毫克干软骨。
所测试的两种探头产生了良好控制的清创效果,边缘光滑,软骨细胞死亡界限明确,延伸至治疗区域约100至200微米深。对治疗区域相邻软骨细胞的代谢活性似乎没有显著影响,但由于样本量小,我们缺乏足够的统计效力来明确确定这些影响。
所测试的两种双极射频探头在正常关节软骨中产生了良好控制的清创效果,边缘光滑,软骨细胞死亡界限明确,延伸至治疗区域约100至200微米深。 (注:原文中“1995 +/- 852 cpm/mg of dry cartilage”中“of”多余,译文已修正)