Tuthill Trevor, Jackson Garrett R, Schundler Sabrina F, Lee Jonathan S, Allahabadi Sachin, Salazar Luis M, McCormick Johnathon R, Jawanda Harkirat, Batra Anjay, Khan Zeeshan A, Mameri Enzo S, Chahla Jorge, Verma Nikhil N
Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, Illinois, U.S.A.
Instituto Brasil de Tecnologia da Saúde, Rio de Janeiro, Brazil and Department of Orthopedics and Traumatology, Federal University of São Paulo (EPM-UNIFESP), São Paulo, Brazil.
Arthrosc Sports Med Rehabil. 2023 Jul 17;5(4):100749. doi: 10.1016/j.asmr.2023.05.006. eCollection 2023 Aug.
To evaluate reported clinical outcomes and complications following radiofrequency (RF) ablation for the treatment of knee chondral lesions.
A literature search was performed according to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines by querying EMBASE, PubMed, and Scopus computerized databases from database inception through October 2022. Level I to IV clinical studies that reported outcomes or complications following RF-based chondroplasty were included. Postoperative outcome scores and complications were aggregated. Study quality was assessed via the Newcastle-Ottawa Scale.
Ten articles from 2002 to 2018 consisting of 1,107 patients (n = 1,504 lesions) were identified. Four studies were of Level I evidence, 3 studies were Level II, 1 study was Level III, and 2 studies were Level IV. The mean patient age was 41.8 ± 6.3 years (range, 12-87). Seven studies (n = 1,037 patients) used bipolar RF devices, and 3 studies (n = 70 patients) used monopolar RF devices. The overall mean postoperative Lysholm, Tegner, and IKDC scores ranged from 83 to 91, 3.8 to 7, and 49 to 90, respectively, in lesions ranging from grade I-IV according to the Outerbridge Classification. Monopolar RF devices reported qualitatively similar mean changes in Lysholm scores (83), Tegner scores (3.8), and IKDC scores (range, 49-69) compared with bipolar RF devices (range, 86.4-91, 4.5-7, 90, respectively). The incidence of complications ranged from 0% to 4%. The most commonly reported complication was osteonecrosis (range, 0% to 4%). The incidence rate of patients undergoing additional surgery ranged from 0% to 4.5%.
The available literature on RF-based chondroplasty shows its efficacy and safety for the treatment of knee chondral lesions, with good clinical outcome scores and low complication and reoperation rates.
Level IV, systematic review of Level I-IV studies.
评估射频（RF）消融治疗膝关节软骨损伤后的临床疗效和并发症。
根据2020年系统评价和Meta分析的首选报告项目指南，通过检索EMBASE、PubMed和Scopus计算机数据库（从数据库建立至2022年10月）进行文献检索。纳入报告基于射频的软骨成形术后疗效或并发症的I至IV级临床研究。汇总术后疗效评分和并发症情况。通过纽卡斯尔-渥太华量表评估研究质量。
共识别出2002年至2018年的10篇文章，涉及1107例患者（n = 1504处损伤）。4项研究为I级证据，3项研究为II级，1项研究为III级，2项研究为IV级。患者平均年龄为41.8±6.3岁（范围12 - 87岁）。7项研究（n = 1037例患者）使用双极射频设备，3项研究（n = 70例患者）使用单极射频设备。根据Outerbridge分类，I - IV级损伤术后Lysholm、Tegner和IKDC总体平均评分分别为83至91、3.8至7、49至90。与双极射频设备（分别为86.4 - 91、4.5 - 7、90）相比，单极射频设备报告的Lysholm评分（83）、Tegner评分（3.8）和IKDC评分（范围49 - 69）的平均变化在性质上相似。并发症发生率为0%至4%。最常报告的并发症是骨坏死（范围0%至4%）。接受二次手术的患者发生率为0%至4.5%。
现有关于基于射频的软骨成形术的文献表明其在治疗膝关节软骨损伤方面的有效性和安全性，临床疗效评分良好，并发症和再次手术率低。
IV级，I - IV级研究的系统评价。
