The effect of radiofrequency energy on the ultrastructure of joint capsular collagen

This study evaluated the effect of radiofrequency energy on the histological and ultrastructural appearance of joint capsular collagen. Femoropatellar joint capsular specimens from adult sheep were treated with one of three treatment temperatures (45 degrees C, 65 degrees C, and 85 degrees C) with a radiofrequency generator or served as control in a randomized block design. Twenty-four specimens (n = 6) were processed for histological examination as well as ultrastructural analysis using transmission electron microscopy. A computer-based area determination program was used to calculate the area affected in histological samples. Histological changes consisted of thermal tissue damage characterized by collagen fiber fusion and fibroblastic nuclear pyknosis at all application temperatures with clear demarcations between treated and untreated tissue. Mean tissue affected ranged from 50.4% for 85 degrees C to 22.5% for 45 degrees C. There was a strong correlation between treatment temperature and percent area affected (P < .001, R-2 = .65). Ultrastructural alterations included a general increase in cross-sectional fibril diameter and loss of fibril size variation with increasing treatment temperature. Longitudinal sections of collagen fibrils showed increased fibril diameter and the loss of cross-striations in the treated groups. Thermally induced ultrastructural collagen fibril alteration is likely the predominant mechanism of tissue shrinkage caused by application of radiofrequency energy.