In vivo study on the short-term effect of radiofrequency energy on chondromalacic patellar cartilage and its correlation with calcified cartilage pathology in an equine model.
Abstract: Chondromalacia can cause joint pain and synovial effusion with the potential for developing into osteoarthritis. Thermal chondroplasty using radiofrequency energy (RFE) has been reported to be superior to mechanical debridement for treating chondromalacia. We compared short-term changes in biomechanical properties of articular cartilage after treatment with monopolar (mRFE) or bipolar RFE (bRFE) or mechanical debridement (MD) on experimentally created grade II chondromalacia patellae. Chondromalacia patellae was created arthroscopically in both patellae of 15 ponies. Ten months after surgery, each patella was randomly assigned to one of four experimental groups: sham operated, untreated control; MD; bRFE; and mRFE. Animals were euthanized 6 months after treatment and fresh osteochondral sections were collected from the treated area, the border of the chondromalacic and nonchondromalacic area, and from two untreated areas for analysis of mechanical properties. The same areas were harvested from an additional six untreated ponies. The aggregate modulus (H(A)), Poisson's ratio (nu(s)), and permeability (k) were determined for each area under creep indentation, and cartilage thickness was measured with a needle probe. The relation between zone of calcified cartilage (ZCC) and mechanical properties of hyaline cartilage (HC) was assessed histomorphometrically. Treated areas of all four groups had inferior mechanical properties compared at the same location. The treated and border areas had significantly lower H(A) values than the untreated areas. Permeability values showed significant differences between bRFE and other treated groups. Chondromalacic areas showed thinning of cartilage compared to nonchondromalacic areas. Biomechanical properties of the injured cartilage were inferior to nonchondromalacic cartilage regardless of the treatment type. mRFE had the highest stiffness value compared to other treatments and significantly higher values than MD. A significant correlation was observed between the mechanical properties of HC and ZCC thickness.
Copyright 2006 Orthopaedic Research Society
Publication Date: 2006-03-04 PubMed ID: 16514662DOI: 10.1002/jor.20108Google Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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This research investigates the short-term effects of radiofrequency energy on degraded knee cartilage, specifically chondromalacia patellae, in ponies, comparing different radiofrequency and mechanical treatments. The study found that all treatments yielded inferior biomechanical properties compared to untreated areas and a significant correlation between the mechanical properties of hyaline cartilage and zone of calcified cartilage thickness.
Study Design and Methodology
- The study involved creating grade II chondromalacia patellae in 15 ponies, done arthroscopically for both patellae.
- After ten months, for each patella, treatment was randomly assigned from four experimental categories: monopolar radiofrequency energy (mRFE), bipolar RFE (bRFE), mechanical debridement, and untreated control.
- Post six months of treatment, osteochondral sections were collected for analysis of their mechanical properties, namely the aggregate modulus, Poisson’s ratio, and permeability. Cartilage thickness was also measured.
- The same process was performed with an additional six untreated ponies for comparison.
- Finally, the relation between the mechanical properties of hyaline cartilage and the zone of calcified cartilage was assessed.
Key Findings
- All treated areas showed inferior biomechanical properties compared to the untreated areas. The treated and border areas demonstrated significantly lower aggregate modulus values than the untreated areas.
- Permeability values revealed significant differences between the bRFE group and the other treated groups.
- Chondromalacic areas showed significant thinning of cartilage compared to non-chondromalacic areas.
- Biomechanical attributes of the injured cartilage were inferior to non-chondromalacic cartilage, regardless of the treatment type.
- mRFE produced the highest stiffness value among the treatments, significantly higher than mechanical debridement.
- A significant correlation was noted between the mechanical properties of hyaline cartilage and the thickness of the zone of calcified cartilage.
Implications of Findings
- The results suggest that while radiofrequency energy may aid in the treatment of chondromalacia patellae, it may not restore the biomechanical properties of the cartilage to their pre-injury state.
- However, among the treatments, mRFE showed a slight advantage with the highest stiffness value, indicating potential preferability for treating chondromalacia patellae.
- The significant correlation between the mechanical properties of hyaline cartilage and zone of calcified cartilage thickness suggests a potential role of calcified cartilage pathology in chondromalacia progression.
Cite This Article
APA
Uthamanthil RK, Edwards RB, Lu Y, Manley PA, Athanasiou KA, Markel MD.
(2006).
In vivo study on the short-term effect of radiofrequency energy on chondromalacic patellar cartilage and its correlation with calcified cartilage pathology in an equine model.
J Orthop Res, 24(4), 716-724.
https://doi.org/10.1002/jor.20108 Publication
Researcher Affiliations
- Department of Medical Sciences, Comparative Orthopedic Research Laboratory, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, Wisconsin 53706, USA.
MeSH Terms
- Animals
- Biomechanical Phenomena
- Calcinosis / pathology
- Cartilage, Articular / pathology
- Chondromalacia Patellae / pathology
- Chondromalacia Patellae / physiopathology
- Chondromalacia Patellae / radiotherapy
- Collagen / analysis
- Disease Models, Animal
- Horses
- Patella / physiopathology
- Permeability
- Radiofrequency Therapy
Citations
This article has been cited 13 times.- Jackson GR, Salazar LM, McCormick JR, Gopinatth V, Hodakowski A, Mowers CC, Dasari S, Fortier LM, Kaplan DJ, Khan ZA, Mameri ES, Knapik DM, Chahla J, Verma NN. Radiofrequency-Based Chondroplasty Creates a Precise Area of Targeted Chondrocyte Death With Minimal Necrosis Outside the Target Zone: A Systematic Review.. Arthrosc Sports Med Rehabil 2023 Aug;5(4):100754.
- Ząbek T, Witarski W, Szmatoła T, Sawicki S, Mrozowicz J, Samiec M. Trichostatin A-Mediated Epigenetic Modulation Predominantly Triggers Transcriptomic Alterations in the Ex Vivo Expanded Equine Chondrocytes.. Int J Mol Sci 2022 Oct 29;23(21).
- Lin C, Deng Z, Xiong J, Lu W, Chen K, Zheng Y, Zhu W. The Arthroscopic Application of Radiofrequency in Treatment of Articular Cartilage Lesions.. Front Bioeng Biotechnol 2021;9:822286.
- Piper D, Taylor C, Howells N, Murray J, Porteous A, Robinson JR. Use of a Novel Variable Power Radiofrequency Ablation System Specific for Knee Chondroplasty: Surgical Experience and Two-Year Patient Results.. Cureus 2021 Jan 22;13(1):e12864.
- Estes R. Adjunct use of radiofrequency coblation for osteochondritis dissecans in children: A case report.. Medicine (Baltimore) 2020 Aug 28;99(35):e21437.
- Koller U, Springer B, Rentenberger C, Szomolanyi P, Waldstein W, Windhager R, Trattnig S, Apprich S. Radiofrequency Chondroplasty May Not Have A Long-Lasting Effect in the Treatment of Concomitant Grade II Patellar Cartilage Defects in Humans.. J Clin Med 2020 Apr 22;9(4).
- Anderson SR, Faucett SC, Flanigan DC, Gmabardella RA, Amin NH. The history of radiofrequency energy and Coblation in arthroscopy: a current concepts review of its application in chondroplasty of the knee.. J Exp Orthop 2019 Jan 14;6(1):1.
- Suarez-Ahedo C, Pavan Vemula S, Stake CE, Finley ZA, Martin TJ, Gui C, Domb BG. What are the current indications for use of radiofrequency devices in hip arthroscopy? A systematic review.. J Hip Preserv Surg 2015 Dec;2(4):323-31.
- Ganguly K, McRury ID, Goodwin PM, Morgan RE, Augé WK 2nd. Targeted In Situ Biosynthetic Transcriptional Activation in Native Surface-Level Human Articular Chondrocytes during Lesion Stabilization.. Cartilage 2012 Apr;3(2):141-55.
- Ganguly K, McRury ID, Goodwin PM, Morgan RE, Augé WK 2nd. Native Chondrocyte Viability during Cartilage Lesion Progression: Normal to Surface Fibrillation.. Cartilage 2010 Oct;1(4):306-11.
- Huber M, Eder C, Loibl M, Berner A, Zellner J, Kujat R, Nerlich M, Gehmert S. RFE based chondroplasty in wrist arthroscopy indicates high risk for chrondocytes especially for the bipolar application.. BMC Musculoskelet Disord 2015 Jan 31;16(1):6.
- Ganguly K, McRury ID, Goodwin PM, Morgan RE, Augé Ii WK. Histopomorphic evaluation of radiofrequency mediated débridement chondroplasty.. Open Orthop J 2010 Jun 29;4:211-20.
- Balcarek P, Kuhn A, Weigel A, Walde TA, Ferlemann KG, Stürmer KM, Frosch KH. Impact of monopolar radiofrequency energy on subchondral bone viability.. Knee Surg Sports Traumatol Arthrosc 2010 May;18(5):673-80.
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