The use of radiofrequency in equine orthopedic surgery
The use of radiofrequency energy (RFE) has become increasingly popular in equine orthopedic surgery in recent years, particularly for the debridement of cartilage lesions and soft tissue resection. However, despite considerable advancements in the technology, the safety and efficacy of RFE have continued to be questioned.
RF devices deliver a high frequency alternating current to create thermal energy enabling tissue excision and ablation. These instruments are divided into those utilizing monopolar energy and those utilizing bipolar energy, differing in their thermal profile and mode of action, with the latter (bipolar) presenting the safer option for use in arthroscopic procedures.
While studies investigating the use of RFE for chondroplasty in the equine population are lacking, there is an abundance of research studies in the human literature assessing its effect on healthy chondrocytes, and researchers are seeking to develop guidelines to minimize collateral damage.
This review article provides a concise and thorough summary of the current use of RFE in equine orthopedics, in addition to discussing the recent evidence surrounding its use for chondroplasty in both the human and equine populations.
Tissue ablation via thermal energy generated by radiofrequency (RF) waves was first described by D’Arsonva in 1891. Cushing and Bovie developed the first electrocautery instrument in 1928 and reported on its ability to reduce bleeding while removing abnormal tissue during intracranial tumor resection. The initial use of RF was largely restricted to percutaneous tumor ablation; however, in 1986, the technology was used in orthopedic surgery for the first time to successfully perform an arthroscopic meniscectomy on a rabbit.
The use of RF in orthopedic procedures continued to advance, and in 1998 Turner et al performed a histological comparison of cartilage lesions treated with RF debridement against those treated with mechanical debridement. In that study, the authors found superior performance of RF in all variables tested, reporting smooth debridement borders with no evidence of collateral tissue damage or chondrocyte death. Subsequent research has provided support to these findings, but some studies have raised concerns regarding the detrimental effects of RFE on surrounding chondrocytes and the underlying matrix.
Researchers concluded that the use of RFE for equine orthopedic procedures, including arthroscopic soft tissue debridement, reveals promising results that reflect the need for, and desirability of, undertaking further research.
Charlotte K. Barton and Laurie R. Goodrich. "The use of radiofrequency in equine orthopedic surgery." Journal of the American Veterinary Medical Association. 26 April 2023. DOI: https://doi.org/10.2460/javma.23.01.0034.
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