Ahrens Philipp, Mueller Dirk, Siebenlist Sebastian, Lenich Andreas, Stoeckle Ulrich, Sandmann Gunther H
Department of Orthopaedic Sports Medicine, Klinikum rechts der Isar, Technische Universitaet Muenchen, Germany, Ismanninger, Str. 22, D- 81675, Muenchen, Germany.
Sportklinik Stuttgart, Taubenheimstraße 8, D-70372, Stuttgart, Germany.
BMC Musculoskelet Disord. 2018 Nov 24;19(1):413. doi: 10.1186/s12891-018-2347-5.
Radio frequency ablation devices have found a widespread application in arthroscopic surgery. However, recent publications report about elevated temperatures, which may cause damage to the capsular tissue and especially to chondrocytes. The purpose of this study was the investigation of the maximum temperatures that occur in the ankle joint with the use of a commercially available radio frequency ablation device.
Six formalin-fixed cadaver ankle specimens were used for this study. The radio frequency device was applied for 120 s to remove tissue. Intra-articular temperatures were logged every second for 120 s at a distance of 3, 5 and 10 mm from the tip of the radio frequency device. The irrigation fluid flow was controlled by setting the inflow pressure to 10 mmHg, 25 mmHg, 50 mmHg and 100 mmHg, respectively. The controller unit voltage setting was set to 1, 5 and 9.
Maximum temperatures exceeding 50 °C/122 °F were observed for all combinations of parameters, except for those with a pressure of 100 mmHg pressure. The main critical variable is the pressure setting, which is highly significant. The controller unit voltage setting showed no effect on the temperature measurements. The highest temperature was 102.7 °C/215.6 °F measured for an irrigation flow of 10 mmHg. The shortest time span to exceed 50 °C/122 °F was 3 s.
In order to avoid temperatures exceeding 50 °C/122 °F in the use of radio frequency devices in arthroscopic surgeries of the ankle joint, it is recommended to use a high irrigation flow by setting the pressure difference across the ankle joint as high as feasible. Even short intervals of a low irrigation flow may lead to critical temperatures above 50 °C/122 °F.
Level II, diagnostic study.
射频消融设备已在关节镜手术中广泛应用。然而，最近的出版物报道了温度升高的情况，这可能会对关节囊组织尤其是软骨细胞造成损伤。本研究的目的是调查使用市售射频消融设备时踝关节内出现的最高温度。
本研究使用了六个经福尔马林固定的尸体踝关节标本。应用射频设备120秒以去除组织。在距射频设备尖端3、5和10毫米处，每隔一秒记录120秒的关节内温度。分别将流入压力设置为10毫米汞柱、25毫米汞柱、50毫米汞柱和100毫米汞柱来控制冲洗液流量。将控制器单元电压设置设置为1、5和9。
除压力为100毫米汞柱的情况外，所有参数组合均观察到最高温度超过50°C/122°F。主要的关键变量是压力设置，其具有高度显著性。控制器单元电压设置对温度测量没有影响。在冲洗流量为10毫米汞柱时测得的最高温度为102.7°C/215.6°F。超过50°C/122°F的最短时间跨度为3秒。
为避免在踝关节镜手术中使用射频设备时温度超过50°C/122°F，建议通过将踝关节两端的压力差设置得尽可能高来使用高冲洗流量。即使短时间的低冲洗流量也可能导致超过50°C/122°F的临界温度。
二级，诊断性研究。
