The effectiveness of the use of electrocautery with chondroplasty in treating chondromalacic lesions: A randomized prospective study.
OBJECTIVE
To determine the clinical effect of electrocautery with arthroscopic chondroplasty on chondromalacic tissue.


METHODS
A randomized, prospective study.


METHODS
In a prospective study, 146 patients were randomly placed in either a control group (chondroplasty alone) or a treatment group (chondroplasty and electrocautery). Intraoperative findings in both treatment and control groups were classified by both the extent of chondromalacia and the number of compartments in which chondromalacia was diagnosed. In our study, we used 6 defined compartments: medial and lateral tibial plateau, medial and lateral femoral condyles, patella, and femoral trochlea. Patients were followed up at 1 year and evaluated using the Lysholm scale. Postoperative Lysholm scores were matched against compartment involvement and compared between groups.


RESULTS
There was no significant difference in the patients with grade 2 chondromalacia in either control or cautery group (P >.5). Groups with grade 3 chondromalacia showed a significant difference favoring the control group (P <.05). A significant difference was found in comparing 2-compartment chondromalacia between the 2 treatment cohorts, again, favoring the control group (P =.01). The remaining groups of multiple compartment chondromalacia showed no significant difference, indicating that the postoperative result was independent of the use of electrocautery.


CONCLUSIONS
This study shows that electrocautery as an adjunct to chondroplasty offers little benefit in the treatment of chondromalacic lesions and may, in fact, limit successful outcome.
Stein
Daniel T
DT
Department of Orthopaedic Surgery, Fountain Valley Regional Hospital, Fountain Valley, California, USA.
Ricciardi
Cosimo A
CA
Viehe
Tom
T
D001182:Arthroscopy / Q000379:methods*; D002357:Cartilage Diseases / Q000473:pathology / Q000601:surgery*; D002358:Cartilage, Articular / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D004564:Electrocoagulation / Q000379:methods*; D006801:Humans; D007717:Knee / Q000601:surgery*; D016896:Treatment Outcome