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Lavage Solution Temperature Influences Depth of Chondrocyte Death and Surface Contouring During Thermal Chondroplasty with Temperature-Controlled Monopolar Radiofrequency Energy

Yan Lu, MD^*, Ryland B. Edwards, III, DVM^*, Shane Nho, Brian J. Cole, MD and Mark D. Markel, DVM, PhD^*,

^* Comparative Orthopaedic Research Laboratory, Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, Department of Orthopedics, Sports Medicine Section, Rush-Presbyterian-St Luke’s Medical Center, Rush University, Chicago, Illinois

Address correspondence and reprint requests to Mark D. Markel, DVM, PhD, Comparative Orthopaedic Research Laboratory, Department of Medical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, 2015 Linden Drive, Madison, WI 53706-1102

Background: Although radiofrequency energy can smooth and contour cartilage surface, it has deleterious effects on chondrocyte viability.

Hypothesis: Monopolar thermal chondroplasty in a 37°C lavage solution, as compared with a 22° lavage solution, will reduce chondrocyte death and result in greater smoothing of the articular cartilage surface.

Study Design: Controlled laboratory study.

Methods: Sixteen chondromalacic samples from patients undergoing total knee arthroplasty were divided into two groups: 22°C and 37°C lavage solution. Each sample was divided into two equal parts and half of each group was treated for 10 seconds and the other half for 15 seconds.

Results: Confocal laser microscopy demonstrated that the depth of chondrocyte death in the 37°C lavage solution group was significantly less (range, 200 to 340 µm) than that in the 22°C solution group for both 10- and 15-second treatment times. Scanning electron microscopy demonstrated that the cartilage surface in the 37°C lavage solution group was smoother than that in the 22°C solution group for the 10-second treatment time. Energy delivery power in the 37°C lavage solution group was significantly lower than in the 22°C solution group for both treatment times.

Conclusions: Thermal chondroplasty with 37°C lavage solution resulted in less depth of chondrocyte death and produced smoother surfaces than with 22°C solution for 10 seconds of treatment.

Clinical Relevance: Less chondrocyte death would permit increased use of thermal chondroplasty.

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