射频能量处理软骨损伤的急性效应

Acute effect of radiofrequency energy on cartilage injury

背景:射频消融能量近年来用于关节软骨损伤的处理,但临床上对其使用时能量设置的大小还存在较大争议。目的:评估不同大小的双极射频消融能量处理Ⅱ级软骨损伤的急性效应,得出射频能量大小与疗效的关系。方法:选取3个新鲜的牛膝关节并建立Ⅱ级关节软骨损伤模型,使用双极射频气化仪在30,50,70,90,110W的不同能量设置下,处理关节损伤区30s,同时设置对照组。结果与结论:扫描电镜检测显示,经双极射频处理后,软骨表面变得平滑,在70W的双极射频能量设置下即可使软骨表面足够光滑;葡糖胺聚糖释放率与射频能量的增加呈反向变化(P<0.05)。结果证实随着射频能量的增加,软骨细胞活性逐渐降低,因此在达到治疗效果的目的下应尽量降低射频能量的大小。

BACKGROUND： Articular cartilage injury has recently been treated with radiofrequency energy. But there still exists controversy about the energy settings of radiofrequency energy in clinical use. OBJECTIVE： To evaluate the acute effect of bipolar radiofrequency energy with varying intensities on grade II cartilage injury, and to explore the relationship between the intensity of radiofrequency energy and curative effect. METHODS： Three fresh bovine joints were selected to establish grade ][ cartilage injury models. Then the joints were treated by the bipolar radiofrequency energy instrument for 30 seconds under different energy settings （30 W, 50 W, 70 W, 90 W, 110 W）. At the same time, the control groups received the corresponding treatment. RESULTS AND CONCLUSION： According to scanning electron microscope, the Cartilage surface became smooth after treatment. Therapeutic effect was achieved under the radiofrequency energy setting of 70 W. There was a negative correlation between glycosaminoglycan release rate and radiofrequency energy intensity （P 〈 0.05）. It indicates that cartilage cell activity decreased with the increasing of radiofrequency energy intensity. Therefore, the radiofrequency energy intensity should be controlled in minimum amount without compromising therapeutic efficacy.