PubMed2002
PURPOSE: Debridment is used to treat Outerbridge grades 2 and 3 lesions in a mechanically aligned and properly tracking patella. It removes fibrillation and provides a stable rim of chondral tissue. Recent basic science reports suggest that radiofrequency probes are superior to mechanical shavers for articular cartilage debridement. The goal of this study was to compare the clinical outcomes of debridement of patellar grade 2 and 3 chondral lesions using radiofrequency and mechanical devices. TYPE OF STUDY: Patients were prospectively randomized into 2 treatment groups. METHODS: Consecutive female patients undergoing arthroscopy for symptomatic, isolated patellar cartilage lesions without evidence of instability, malalignment, or patellar tracking dysfunction were prospectively randomized into radiofrequency and mechanical debridement groups based on medical record number. All patients had failed a 6-month course of conservative treatment and had chondral pathology documented by magnetic resonance imaging. Patients were assessed before and after surgery using the Fulkerson-Shea Patellofemoral Joint Evaluation Score. RESULTS: Nineteen patients (mean age, 37.5 years) underwent chondral debridement using a mechanical shaver and 20 patients (mean age, 36.9 years) underwent chondral debridement using a bipolar radiofrequency probe at nonablative energy levels. The mechanical group had a mean preoperative score of 59.2 and the radiofrequency group had a mean preoperative score of 59.6. Postoperative scores at 12-month follow-up were 80.0 for the mechanical group and 87.9 for the radiofrequency group (P =.0031). At 24 months, the mean score of the mechanical group was 77.5 and the mean of the radiofrequency group was 86.6 (P =.0006). CONCLUSIONS: This study presents clear evidence of superior clinical outcome of debridement of patellar grade 2 and 3 chondral lesions with the use of bipolar radiofrequency versus a mechanical shaver.