Matthews, Brent, Wilkinson, Matthew, McEwen, Peter, Hazratwala, Kaushik, Doma, Kenji, Manoharan, Varaguna, Bahho, Zaid, and McEwen, Shannon (2017) In vivo arthroscopic temperatures: a comparison between 2 types of radiofrequency ablation systems in arthroscopic anterior cruciate ligament reconstruction—a randomized controlled trial. Arthroscopy, 33 (1). pp. 165-172.

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Abstract

Purpose: To compare a plasma ablation device with a standard ablation device in anterior cruciate ligament (ACL) reconstruction to determine which system is superior in terms of intra-articular heat generation and diathermy efficiency.

Methods: This was a prospective, randomized controlled trial. The inclusion criteria were adult patients undergoing primary ACL reconstruction. Patients were randomized preoperatively to the standard ablation group or the plasma ablation group. A thermometer was inserted into the inferior suprapatellar pouch, and the temperature, time, and duration of radiofrequency ablation were measured continually.

Results: No significant differences were found between the standard ablation system and the plasma ablation system for maximum temperature (29.77°C and 29.34°C, respectively; P =.95), mean temperature (26.16°C and 26.99°C, respectively; P =.44), minimum temperature (22.66°C and 23.94°C, respectively; P =.54), and baseline temperature (26.80°C and 27.93°C, respectively; P =.35). Similarly, no significant differences were found for operative time (82.90 minutes and 80.50 minutes, respectively; P =.72) and mean diathermy activation times (2.6 minutes for both systems; P =.90). The between-system coefficient of variation for the measured parameters ranged from 0.12% to 3.69%. No intra-articular readings above the temperature likely to damage chondrocytes were recorded. The mean irrigation fluid temperature had a significant correlation with the maximum temperature reached during the procedure (Spearman rank correlation, r = 0.87; P < .01).

Conclusions: No difference in temperature was observed between the standard ablation and plasma ablation probes during ACL reconstruction. Temperatures did not exceed critical temperatures associated with chondrocyte death. Level of Evidence Level I, randomized controlled trial.

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