Neuronal regeneration after application of radiofrequency energy to collagenous tissue is affected by limb immobilization: an in vivo animal study.
Despite widespread use of radiofrequency (RF)-shrinkage, there have been no studies on the influence of RF-energy on neural elements of collagenous tissue. The purpose of this study was to examine the effect of RF-shrinkage on neural structures of capsuloligamentous tissue and the recovery of neural elements under different postoperative treatment protocols. One patellar tendon of 46 New-Zealand-White rabbits was shrunk. Six rabbits were sacrificed immediately postoperative. Twenty rabbits were not immobilized, 10 were immobilized for 3 and 10 were immobilized for 6 weeks. A monoclonal antibody, specific against a neurofilament protein, was used to detect nerves and neural structures. Staining pattern of nerve fibres was significantly altered immediately postoperative. After 3 weeks the number of nerve fibres and bundles decreased significantly in immobilized and non-immobilized limbs. The loss of nerve fibres was significantly less in immobilized limbs. At 6 weeks the number of neural elements in immobilized limbs increased to the level of untreated control tissue. In non-immobilized limbs we found no recovery of neural elements 9 weeks postoperatively. At this time the number of nerve fibres and bundles was still significantly less compared to the untreated control limbs. RF-shrinkage causes significant alteration of neural elements. Under immobilization nerve fibres and bundles reach the level of normal untreated tissue. Careful rehabilitation is important after RF-shrinkage. Not only for biomechanical reasons, but also to allow the neural elements to recover, thermally modified tissue should be protected from normal physiologic loads.
Department of Orthopaedics, University Hospital Münster, Albert-Schweitzer Street 33, 48149, Germany. poetzl@uni-muenster.de
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W
Pötzl
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Kümpers
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T
Szuwart
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T
Filler
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Marquardt
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Steinbeck
D000818:Animals; D017115:Catheter Ablation; D006979:Hyperthermia, Induced; D007103:Immobilization; D007719:Knee Joint / Q000294:innervation / Q000601:surgery; D009412:Nerve Fibers / Q000502:physiology; D009416:Nerve Regeneration / Q000528:radiation effects*; D010329:Patella; D011183:Postoperative Complications / Q000517:prevention & control; D011434:Proprioception; D011817:Rabbits; D013710:Tendons / Q000294:innervation* / Q000601:surgery*