Using thermal energy to smooth chondromalacic cartilage in vitro

Purpose: The purpose of this study is to test the hypothesis that thermal treatment of grade III chondromalacia using radiofrequency energy (RFE) results in greater cartilage smoothing as compared to mechanical debridement and as compared to no treatment. Methods: Fresh human articular cartilage specimens were obtained from patients undergoing total knee arthroplasty for osteoarthritis. One-centimeter square grade ill chondromalacia lesions were identified and randomly assigned to thermal chondroplasty, mechanical chondroplasty or no treatment groups. Digital video arthroscopy images were recorded, demonstrating the lesions pre- and post-treatment. Outcomes were assessed using a visual analog scale (VAS) by five orthopedic surgeons who were blinded to the treatment groups. Analysis of variance was performed to detect differences in mean smoothing scores among the three groups. Results: Mean VAS smoothing score was 7.0 for the thermal group, 4.4 for the mechanical group, and 1.7 for the no treatment group. These three values are all statistically significantly different (p\u3c0.05). Conclusion and Recommendations: Our results demonstrate that thermal chondroplasty produces significantly smoother cartilage than mechanical chondroplasty or no treatment. We recommend future research to determine whether improved cartilage smoothing results in improved in vivo outcomes over time