Effects of radiofrequency probe application on irrigation fluid temperature in the wrist joint.
OBJECTIVE
Radiofrequency (RF) probes used in wrist arthroscopy may raise joint fluid temperature, increasing the risk of capsular and ligamentous damage. The purposes of the current study were to measure joint fluid temperature during wrist arthroscopy with the use of RF probes, and to determine whether using an outlet portal will reduce the maximum temperature.


METHODS
We performed wrist arthroscopy on 8 cadaveric arms. Ablation and coagulation cycles using RF probe were performed at documented locations within the joint. This was done for 60-second intervals on both the radial and ulnar side of the wrist, to mimic clinical practice. We used 4 fiberoptic phosphorescent probes to measure temperature (radial, ulnar, inflow-tube, and outflow-tube probes) and measured joint fluid temperature with and without outflow.


RESULTS
There was a significant difference between wrists with and without outflow when examining maximum ablation temperatures (p < .002). All specimens showed higher maximum and average ablation temperatures without outflow. Maximum joint temperatures, greater than 60 degrees C, were observed in only no-outflow conditions.


CONCLUSIONS
In performing RF ablation during wrist arthroscopy, the use of an outlet portal reduces the joint fluid temperature. Without an outlet portal, maximum temperatures can exceed desirable levels when using ablation; such temperatures have the potential to damage adjacent tissues. It is useful to maintain adequate outflow when using the radiofrequency probes during wrist arthroscopy.
Sotereanos
Dean G
DG
Department of Orthopaedic Surgery, Hand and Upper Extremity Surgery, and the Orthopaedic Biomechanics Research Laboratory, Allegheny General Hospital, University of Pittsburgh, Pittsburgh, PA 15261, USA.
Darlis
Nickolaos A
NA
Kokkalis
Zinon T
ZT
Zanaros
George
G
Altman
Gregory T
GT
Miller
Mark Carl
MC
D001182:Arthroscopy / Q000009:adverse effects*; D001831:Body Temperature / Q000502:physiology*; D016923:Cell Death / Q000502:physiology; D004322:Drainage; D004564:Electrocoagulation / Q000009:adverse effects* / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D012307:Risk Factors; D013582:Synovial Fluid / Q000502:physiology*; D014955:Wrist Joint / Q000503:physiopathology* / Q000601:surgery*