title: Radiofrequency energy in the arthroscopic treatment of knee chondral lesions: a systematic review.
abstract: BACKGROUND
  Cartilage debridement is one of the recommended procedures for the management of chondral defects. Radiofrequency probes allow to debride the cartilage, but may induce subchondral bone necrosis.
  
  
  METHODS
  Medline, Cochrane and Google Scholar were searched to identify studies on arthroscopic debridement of the articular cartilage of the knee using radiofrequency chondroplasty. The methodological quality of the studies was assessed using the Coleman methodology score (CMS).
  
  
  RESULTS
  Monopolar and bipolar radiofrequency devices provide significantly better clinical outcomes, especially for patients with high-grade chondral lesions, compared with mechanical shaver only. Despite the original concerns regarding subchondral bone necrosis, low complication rates are reported.
  
  
  RESULTS
  Heterogeneity in terms of type of device does not allow sound comparison of the published results. There is lack of evidence on the long-term effects of radiofrequency chondroplasty.
  
  
  CONCLUSIONS
  Study methodology should be improved: the average Coleman methodology score was 56.2 out of 100.
  
  
  METHODS
  More comparative, well-designed and larger cohort trials are needed to ascertain whether radiofrequency chondroplasty offers long-term benefits over other simpler and more economical alternatives.
authors: Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Via Alvaro del Portillo 200, Rome, Italy.
authors: Papalia
authors: P
authors: Rocco
authors: Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Via Alvaro del Portillo 200, Rome, Italy.
authors: Diaz Balzani
authors: DB
authors: Lorenzo
authors: Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Via Alvaro del Portillo 200, Rome, Italy.
authors: Torre
authors: T
authors: Guglielmo
authors: Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Via Alvaro del Portillo 200, Rome, Italy.
authors: Paciotti
authors: P
authors: Michele
authors: Department of Musculoskeletal Disorders, Faculty of Medicine and Surgery, University of Salerno, 84081 Baronissi, Salerno, Italy Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London E1 4DG, UK n.maffulli@qmul.ac.uk.
authors: Maffulli
authors: M
authors: Nicola
authors: Department of Orthopaedic and Trauma Surgery, Campus Biomedico University of Rome, Via Alvaro del Portillo 200, Rome, Italy.
authors: Denaro
authors: D
authors: Vincenzo
mesh_terms: D001182:Arthroscopy / Q000379:methods*; D002358:Cartilage, Articular / Q000293:injuries* / Q000601:surgery; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods*; D003646:Debridement / Q000379:methods; D006801:Humans; D007718:Knee Injuries / Q000601:surgery*; D007719:Knee Joint / Q000601:surgery; D010020:Osteonecrosis / Q000209:etiology
keywords: Coleman methodology score; chondral lesion; debridement; knee arthroscopy; radiofrequency; systematic review