COMPARISON OF RADIOFREQUENCY ABLATION WITH MECHANICAL SHAVING ON TENDON: HISTOLOGICAL AND ULTRASTRUCTURAL ANALYSIS

Abstract

Aim Radio-frequency electrical energy and mechanical shaving are often used for resection of soft tissues during arthroscopic reconstructive procedures. The effects of these techniques on tendon are not yet clearly understood. This study compared the effects of radio-frequency ablation with mechanical shaving on ovine tendon, using histological and ultra-structural techniques.

Methods: A single cut using a scalpel blade was used to create a standardised reproducible lesion in 12 freshly harvested ovine infraspinatus tendons. Each lesion was then subjected to either bipolar radio-frequency ablation or mechanical shaving. Specimens were then processed for light and electron microscopy.

Results: The radio-frequency treated samples showed an area of coagulative necrosis with an average diameter of 2 mm around the lesion. Conversely, the shaved samples showed viable cells up to the edges of the lesion. These findings were supported by ultra-structural appearances, which showed preservation of tendon architecture in shaved samples and widespread denaturation of the tendon matrix with loss of fibrillar structure in the radio-frequency treated samples.

Conclusion: These results indicate that thermal resection of tendon causes an immediate additional 2 mm area of tissue necrosis which is not present after mechanical shaving. These findings may have implications for the success of arthroscopic debridement and tendon repair procedures.