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膝关节镜下半月板切除术的射频控制消融技术

Radiofrequency Controlled Ablation Technique for Arthroscopic Meniscectomy of the Knee.

作者信息

Carroll Amber, Brice Chris, Malempati Chaitu

机构信息

Orthopaedic Surgery and Sports Medicine, University of Kentucky Med Center Health, Bowling Green, Kentucky, U.S.A.

出版信息

Arthrosc Tech. 2025 Feb 8;14(4):103316. doi: 10.1016/j.eats.2024.103316. eCollection 2025 Apr.

Abstract

Despite mixed responses in the literature regarding knee arthroscopies, radiofrequency (RF) ablation remains a preferred method for partial meniscectomy of the knee. This technique is believed to offer advantages over traditional shaving methods, such as reduced risk of long-term fissure propagation and enhanced precision. However, existing literature does not yield a conclusive status of RF's risk-benefit profile, contributing to a mixed response to its recognized utility and safety in the arthroscopic community. This article details a procedure for performing partial meniscectomy with RF ablation using a feedback-controlled bipolar RF device (WEREWOLF FLOW50 Wand; ArthroCare/Smith & Nephew, Austin, TX), with a focus on parameters that can influence intervention safety. These parameters include device-specific factors such as energy transmission type and field density, as well as surgeon-specific factors such as rest/shutoff time, translation speed, and instrumentation depth. Postoperative care typically involves physical therapy, emphasizing early mobilization and strengthening exercises to ensure optimal recovery. Although our clinic has observed positive results with feedback-controlled bipolar RF for partial meniscectomy, further studies are necessary to conclusively determine the risk-benefit profile of this technique, including long-term follow-up to assess durability and patient satisfaction. Additionally, comparisons with other techniques could provide a more comprehensive understanding of its efficacy and overall impact on patient outcomes.

摘要

尽管文献中对于膝关节镜检查的反应不一,但射频(RF)消融仍是膝关节部分半月板切除术的首选方法。据信,该技术比传统的刨削方法具有优势,比如降低长期裂隙扩展的风险以及提高精准度。然而,现有文献并未得出关于射频风险效益状况的确切结论,这导致关节镜领域对其公认的效用和安全性反应不一。本文详细介绍了使用反馈控制双极射频设备(WEREWOLF FLOW50手持器;ArthroCare/施乐辉公司,德克萨斯州奥斯汀)进行射频消融半月板部分切除术的步骤,重点关注可能影响干预安全性的参数。这些参数包括特定设备因素,如能量传输类型和场密度,以及特定医生因素,如休息/关闭时间、平移速度和器械插入深度。术后护理通常包括物理治疗,强调早期活动和强化锻炼以确保最佳恢复。尽管我们诊所观察到反馈控制双极射频用于半月板部分切除术取得了积极效果,但仍需进一步研究以最终确定该技术的风险效益状况,包括进行长期随访以评估其持久性和患者满意度。此外,与其他技术进行比较可以更全面地了解其疗效以及对患者预后的总体影响。

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