Anterior cruciate ligament rupture after thermal treatment in a canine model.
BACKGROUND
The use of radiofrequency energy to treat damaged anterior cruciate ligaments is gaining popularity. However, complete rupture of the ligament after treatment has been reported.


OBJECTIVE
To evaluate the effect of thermal energy applied arthroscopically to normal, intact anterior cruciate ligaments in mature dogs.


METHODS
Controlled laboratory study.


METHODS
Monopolar radiofrequency energy was applied to the normal anterior cruciate ligament of 1 knee in 18 dogs. The contralateral anterior cruciate ligament (also normal) was sham treated. Force-plate gait analysis was performed preoperatively and at 4, 8, 12, 16, 26, and 36 weeks after surgery. Anterior cruciate ligament rupture was detected by a sudden onset of nonweightbearing and a positive drawer sign.


RESULTS
All treated ligaments ruptured approximately 55 days after surgery (mean, 55 days; standard error, 1.6).


CONCLUSIONS
Although monopolar radiofrequency energy may have some potential in the treatment of lax anterior cruciate ligaments, in the application described here the result was a highly predictable deterioration and rupture of all treated anterior cruciate ligaments.


CONCLUSIONS
On the basis of these findings, we strongly recommend that strict selection and application criteria be used when considering use of this modality on anterior cruciate ligaments that are stretched or partially disrupted, or both. Use of this modality should be followed by adherence to a highly conservative rehabilitation protocol.
Lopez
Mandi J
MJ
Comparative Orthopaedic Research Laboratory, Department of Medical Sciences, Veterinary Medical Teaching Hospital, University of Wisconsin-Madison, Madison, Wisconsin 53706, USA.
Markel
Mark D
MD
D000704:Analysis of Variance; D000818:Animals; D016118:Anterior Cruciate Ligament / Q000528:radiation effects / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D001182:Arthroscopy / Q000009:adverse effects; D004285:Dogs; D004598:Electrosurgery / Q000009:adverse effects*; D005260:Female; D005684:Gait / Q000502:physiology; D007719:Knee Joint / Q000473:pathology* / Q000503:physiopathology; D023421:Models, Animal; D010020:Osteonecrosis / Q000209:etiology; D012421:Rupture / Q000209:etiology; D013997:Time Factors