双极射频能量处理时间可影响软骨细胞活性和软骨表面轮廓

背景：射频能量已用于处理关节软骨损伤,但其安全性受到质疑。目的：在体外模拟关节镜条件下使用双极射频能量处理软骨损伤,分别通过葡萄胺聚糖检测和扫描电镜观察评估软骨细胞的活力和表面轮廓。方法：无菌条件下,应用双极射频能量分别处理新鲜牛膝关节软骨10,20,30,40和50 s。处理后取下全层关节软骨,每个标本分为2部分,一部分通过检测葡萄胺聚糖释出率评估软骨细胞的活性,另一部分通过扫描电镜评估软骨的表面轮廓。结果与结论：双极射频能量对软骨细胞造成时间相关的有害效应,软骨细胞的活性与处理时间呈负相关。表面轮廓的光滑度与处理时间呈正相关,处理时间大于20 s才可充分光滑软骨表面,达到扫描电镜评分的2分。提示应用双极射频能量处理关节软骨损伤时,软骨细胞的活性和表面轮廓的光滑度与处理时间相关,应谨慎使用射频能量处理关节软骨损伤直至其长期效应得到评估。

Effects of bipolar radiofrequency energy treatment time on chondrocyte viability and surface contouring

BACKGROUND: More recently, radiofrequency energy (RFE) has been used to treat articular cartilage defects. However, the safety of these devices remains controversial. OBJECTIVE:To evaluate chongdrocyte viability and surface contouring of articular cartilage through glycosaminoglycan (GAG) detection and scanning electron microscopy (SEM), respectively during different treatment time periods with bipolar radiofrequency energy (bRFE). METHODS:Three fresh knees served as the experimental specimens for the study. Under sterile conditions, bRFE was used to treat the articular surface with different treatment time. Five RFE treatment time periods included 10, 20, 30, 40 and 50 seconds. Full-thickness articular cartilage was then harvested from the treatment areas. Each specimen was divided into two distinct regions. Six specimens per treatment time were then assessed for chondrocyte viability through measuring the release rate of GAG; six specimens per treatment time were then assessed for the surface contouring of articular cartilage using SEM; and twelve additional untreated specimens were obtained to serve as controls for chondrocyte viability and surface contouring．RESULTS AND CONCLUSION:bRFE used for articular cartilage defects induced a dose-dependent detrimental effect on chongdrocyte and chongdrocyte viability was negatively correlated with the treatment time. However, articular cartilage smoothness degree was positively correlated with the treatment time. bRFE required a minimum of 20 seconds to smooth the cartilage surface sufficiently to reach the SEM score of 2. When bRFE was used to treat articular cartilage injury, chongdrocyte viability and articular cartilage smoothness degree were associated with the treatment time. Cautions should be taken in use of RFE for treatment of articular cartilage injury until long-term effects are evaluated.