The temperature profile in elbow arthroscopy using radiofrequency ablation.

Area of Science:

• Orthopedic Surgery
• Minimally Invasive Procedures
• Biomedical Engineering

Background:

• Arthroscopic surgery is increasingly utilized for its minimally invasive benefits.
• Elbow arthroscopy presents unique challenges and potential risks.
• Investigating thermal effects during radiofrequency ablation is crucial for patient safety.

Purpose of the Study:

• To assess temperature development in the elbow joint during radiofrequency ablation in arthroscopic surgery.
• To evaluate the safety of radiofrequency ablation concerning thermal spread.
• To determine safe usage parameters for radiofrequency ablation in elbow arthroscopy.

Main Methods:

• Cadaveric elbow models (n=7) underwent arthroscopic procedures with posterolateral, transtricipital, and anterolateral approaches.
• Bipolar radiofrequency ablation (bRFA) was applied at specific locations with and without irrigation.
• Temperature probes monitored joint temperatures, particularly near the olecranon fossa and ulnar nerve.

Main Results:

• Radiofrequency ablation without irrigation caused rapid intra-articular temperature increases within 5 seconds.
• Significant temperature rise was observed in the olecranon fossa without irrigation (p=0.0052).
• With continuous irrigation, temperatures near the ulnar nerve remained below 41°C within 30 seconds (p=0.0747).

Conclusions:

• Radiofrequency ablation is safe for elbow arthroscopy when utilized with continuous irrigation.
• Unirrigated radiofrequency ablation should be limited to 3-second applications.
• Thermal effects of radiofrequency ablation are unlikely to adversely impact the ulnar nerve despite its proximity.