SCIENTIFIC ARTICLE Effects on the Distal Radioulnar Joint of Ablation of Triangular Fibrocartilage Complex Tears With Radiofrequency Energy Michaela Huber, MD, * Markus Loibl, MD, * Christoph Eder, MD, * Richard Kujat, PhD,† Michael Nerlich, MD, PhD, * Sebastian Gehmert, MD‡ Purpose This cadaver study investigated the temperature profile in the wrist joint and distal radioulnar joint (DRUJ) during radiofrequency energy (RFE) application for triangular fibrocartilage complex resection. Methods An arthroscopic partial resection of the triangular fibrocartilage complex using monopolar and bipolar RFE was simulated in 14 cadaver limbs. The temperature was recorded simultaneously in the DRUJ and at 6 other anatomic locations of the wrist during RFE application. Results The mean temperature in the DRUJ was 43.3  8.2  C for the bipolar system in the ablation mode (60 W) and 30.4  3.4  C for the monopolar system in the cut mode (20 W) after 30 seconds. The highest measured temperature in the DRUJ was 54.3  C for the bipolar system and 68.1  C for the monopolar system. Conclusions The application of RFE for debridement or resection of the triangular fibrocartilage complex in a clinical setting can induce peak temperatures that might cause damage to the cartilage of the DRUJ. Bipolar systems produce higher mean temperatures than monopolar devices. Clinical relevance RFE application increases the mean temperature in the DRUJ after 30 seconds to a level that may jeopardize cartilage tissue. (J Hand Surg Am. 2016;-(-):-e-. Copyright Ó 2016 by the American Society for Surgery of the Hand. All rights reserved.) Key words Temperature, cartilage DRUJ, RFE, wrist, arthroscopy. A RTHROSCOPIC DEBRIDEMENT OF CENTRAL trian- gular fibrocartilage complex (TFCC) tears to a stable rim has become a standard procedure during the last 2 decades with good long-term results. 1e6 A smooth sealed rim of the remaining TFCC edges after mechanical resection 7,8 is achieved by collagen shrinkage, using radiofrequency energy (RFE) that starts at a temperature of 65  C. 9 However, it is known that cartilage damage may occur at temperatures between 45  C and 55  C because of overheating of the joint, even under vigorous irrigation. 10e12 It is theorized that the heat energy is focused in the area 1 mm around the smooth sealed rim during RFE application. 13 However, a recent study revealed that temperatures above 50  C can be detected even at a 5-mm radius from the probe. 14 Thus, unexpected cartilage damage may be induced during resection of the TFCC. 8 To date, no data exist regarding the temperature distribution in the distal radioulnar joint (DRUJ) and the adjacent anatomical structures during RFE appli- cation for TFCC tears. The objective of this study was to obtain temperature profiles during simulated arthroscopic debridement of the TFCC, especially in From the *Department of Trauma Surgery, University Medical Center Regensburg; the †Center for Medical Biotechnology, University of Regensburg, Regensburg, Germany; and the ‡Department of Orthopedic Surgery, University Hospital Basel, Basel, Switzerland. Received for publication October 5, 2015; accepted in revised form August 12, 2016. No benefits in any form have been received or will be received related directly or indirectly to the subject of this article. Corresponding author: Michaela Huber, MD, Department of Trauma Surgery, University Medical Center Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany; e-mail: michaela1.huber@klinik.uni-regensburg.de. 0363-5023/16/---0001$36.00/0 http://dx.doi.org/10.1016/j.jhsa.2016.08.013 Ó 2016 ASSH r Published by Elsevier, Inc. All rights reserved. r 1