Longo Umile Giuseppe, Presti Daniela Lo, Orozco Youssef Raffoul Arab, Neyjat Dario, De Salvatore Sergio, De Tommasi Francesca, D'Hooghe Margaux, de Sire Alessandro, Samuelsson Kristian
Fondazione Policlinico Universitario Campus Bio-Medico Roma Italy.
Department of Medicine and Surgery, Research Unit of Orthopaedic and Trauma Surgery Università Campus Bio-Medico di Roma.
J Exp Orthop. 2025 Jun 1;12(2):e70297. doi: 10.1002/jeo2.70297. eCollection 2025 Apr.
Radiofrequency works by applying continuous waveforms which ablate the surface of the cartilage. Despite its utility, the limits and possible risks of this technology have not been thoroughly investigated in the literature. This review aims to systematically summarise the most recent studies regarding the effects of the various radiofrequency on cartilage and compare the side effects they may bring.
A search following the PRISMA guidelines was conducted on scientific databases: Web of Science, Embase CINAHL, ProQuest and Medline from May 2021 to January 2025. The databases were searched from their inception to September 2023. Only articles in English were included. In vivo, ex vivo, cadaveric, and in vitro studies were all included. To assess the risk of bias, Rob2 and ROBINS-I were used.
Twenty-eight studies were included in this systematic review. The level of evidence of the included studies ranged from level II to III. The most analysed specimen was human tissue, followed by swine, ovine, bovine, equine, canine and rabbit. Cartilage damage was reported in most of the articles. Monopolar radiofrequency was considered safer than bipolar radiofrequency. However, controversial results were found on the superiority of radiofrequency energy to mechanical debridement.
This review shows that there is not enough evidence to precisely identify the possible dangers or benefits that may come from the use of radiofrequency energy on cartilage. Therefore, the real risks of radiofrequency are not fully explored. Further research needs to include radiofrequency energy in the clinical and surgical environment.
Level II, evidence from one or more well designs randomised control trials (RCT).
射频通过施加连续波形来消融软骨表面发挥作用。尽管其具有实用性，但该技术的局限性和潜在风险在文献中尚未得到充分研究。本综述旨在系统总结关于各种射频对软骨影响的最新研究，并比较它们可能带来的副作用。
按照PRISMA指南，于2021年5月至2025年1月在科学数据库进行检索：Web of Science、Embase、CINAHL、ProQuest和Medline。对数据库从创建至2023年9月进行检索。仅纳入英文文章。纳入体内、体外、尸体和离体研究。使用Rob2和ROBINS - I评估偏倚风险。
本系统综述纳入28项研究。纳入研究的证据水平为II级至III级。分析最多的标本是人体组织，其次是猪、羊、牛、马、犬和兔。大多数文章报道了软骨损伤。单极射频被认为比双极射频更安全。然而，关于射频能量优于机械清创术存在有争议的结果。
本综述表明，没有足够证据精确识别使用射频能量对软骨可能带来的危险或益处。因此，射频的实际风险尚未得到充分探索。进一步研究需要将射频能量纳入临床和手术环境中。
II级，来自一项或多项设计良好的随机对照试验（RCT）的证据。
