Shaver, bipolar radiofrequency, and saline jet instruments for cutting meniscal tissue: a comparative experimental study on sheep menisci.

ABSTRACT

PURPOSE: The purpose of this study was to compare the quality of meniscal tissue cut with 3 different surgical instruments (traditional shavers, bipolar radiofrequency (RF) wands, and a high-pressure saline jet) and that of control menisci. TYPE OF STUDY Experimental design, biochemical and histologic study. METHODS: Sixty samples of sheep menisci were separated into 4 groups. Three groups were shaved on the apical surface with the different instruments. The smoothness of the cut surfaces was evaluated visually by an orthopaedic surgeon and then scored by laser scanning cytometry and by line measurement analysis. The depth of tissue damage was measured by fluorescent cytochemistry. Means and standard deviations were calculated and comparative statistics used (P < .05). RESULTS: The edges cut by the saline jet and bipolar RF were significantly smoother when judged by the surgeon than those cut by traditional shaver. There was no significant difference between the saline jet and bipolar RF. There were no significant differences in smoothness when measured by laser scanning cytometry or by line measurement techniques. The control menisci had less depth of damage along the edge as measured by fluorescent cytochemistry than did any of the menisci cut with the instrument. The saline jet had significantly less depth of damage than did the shaver. No other significant differences existed between the instruments for depth of damage. CONCLUSIONS: The results of our investigation conclude that high-pressure saline instruments may cause less damage to residual meniscal tissue when compared with bipolar RF and shavers. Saline jets and bipolar RF also produce a smoother cut than shavers. CLINICAL RELEVANCE Surgeons may want to consider the degree of residual damage to meniscal tissue from the application of various surgical instruments. Saline jets may be a superior cutting instrument than RF or shavers when considering depth of residual damage and smoothness of residual meniscal edges.