title: Temperature profile of radiofrequency probe application in wrist arthroscopy: monopolar versus bipolar.
abstract: OBJECTIVE
  The purpose of this study was to investigate the changes in temperature during wrist arthroscopy comparing monopolar and bipolar radiofrequency energy (RFE).
  
  
  METHODS
  A standard wrist arthroscopy was performed on 14 arms of 7 cadavers without irrigation or with continuous irrigation with 0.9% saline solution and gravity-assisted outflow through an 18-gauge needle. We treated 7 wrists with a bipolar device (VAPR II with 2.3-mm side effect electrodes; DePuy Mitek, Westwood, MA) and 7 wrists with a monopolar device (OPES Ablator for small joints, 45°; Arthrex, Naples, FL). The temperature was recorded simultaneously from 7 predefined anatomic landmarks.
  
  
  RESULTS
  We observed an increase in the temperature corresponding to the time of energy application. The highest measured peak temperatures were 52°C (monopolar) and 49.5°C (bipolar) without irrigation. Continuous irrigation led to a significant reduction in the temperature at the site of the energy application. The mean temperature decreased by 7°C for the monopolar system and 5°C for the bipolar system when irrigation was used. For both radiofrequency devices, we found a decrease in the temperature proportional to the distance of the sensors to the radiofrequency probe.
  
  
  CONCLUSIONS
  Monopolar and bipolar RFE can be safely used in wrist arthroscopy if a continuous irrigation system is applied and the energy impulse does not exceed 5 to 10 seconds. However, it should be used with great care to avoid local heat damage especially at the cartilage.
  
  
  CONCLUSIONS
  This basic science study was performed to gain data concerning the temperature in wrist arthroscopy and to broaden the knowledge about the risks when using RFE. Furthermore, we sought to control side effects of RFE by finding the best applied form of RFE regarding duration and pulsation (monopolar/bipolar).
authors: Department of Trauma, Plastic & Hand Surgery, University Medical Center Regensburg, Regensburg, Germany. michaela1.huber@klinik.uni-regensburg.de
authors: Michaela
authors: M
authors: Huber
authors: Christoph
authors: C
authors: Eder
authors: Michael
authors: M
authors: Mueller
authors: Richard
authors: R
authors: Kujat
authors: Christina
authors: C
authors: Roll
authors: Michael
authors: M
authors: Nerlich
authors: Lukas
authors: L
authors: Prantl
authors: Sebastian
authors: S
authors: Gehmert
mesh_terms: D001182:Arthroscopy; D001831:Body Temperature; D002102:Cadaver; D017115:Catheter Ablation; D006801:Humans; D007507:Therapeutic Irrigation; D014955:Wrist Joint / Q000601:surgery*