Influence of Postoperative Immobilization on Tendon Length after Radiofrequency-Induced Shrinkage: An in Vivo Rabbit Study

• Published in: The American journal of sports medicine 2003-01, Vol.31 (1), p.36-40
• Main Authors: Pötzl, Wolfgang, Witt, Kai-Axel, Hackenberg, Lars, Heusner, Till, Steinbeck, Joern
• Format: Article
• Language: English
• Subjects: Animals; Biological and medical sciences; Catheter Ablation - methods; Diseases of the osteoarticular system; Immobilization - physiology; Medical sciences; Miscellaneous. Osteoarticular involvement in other diseases; Orthopedic surgery; Patella - surgery; Postoperative Care - methods; Rabbits; Risk Factors; Sports medicine; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tendons; Tendons - physiology; Tendons - surgery; Time Factors
• ISSN: 0363-5465; 1552-3365
• DOI: 10.1177/03635465030310011701

Background Despite the widespread use of radiofrequency-induced shrinkage of collagenous tissues, there have been no animal studies on the effects of postoperative immobilization after such treatment. Purpose To examine the effects of postoperative immobilization after radiofrequency energy treatment, with special emphasis on any tissue length increases. Study Design Controlled laboratory study. Methods The right patellar tendon of 60 New Zealand White rabbits was shrunk with a radiofrequency probe. Tendon length was measured intraoperatively before and after shrinkage and via radiographs immediately postoperatively and at 3, 6, and 9 weeks. Twenty rabbits were not immobilized, 20 were immobilized for 3 weeks, and 20 were immobilized for 6 weeks. Results In the nonimmobilized limbs, the tendon length increased 34.9% at 3 weeks and another 2.5% at 6 weeks, versus 11.2% at 3 weeks and 6.6% at 6 weeks in the immobilized limbs. Ten of the 20 rabbits that were immobilized for 6 weeks were sacrificed at 9 weeks and were found to have a further length increase of 10.8%. At 9 weeks, the tendons of this group were no longer significantly shorter than the tendons from rabbits that had not been immobilized. Conclusions Careful postoperative rehabilitation is imperative after radiofrequency-induced shrinkage. Without protection, exposure to normal physiologic loads places the shrunken tissue at risk of stretching out beyond the preshrinkage length. Clinical Relevance Shrunken tissue is at risk of stretching out after radiofrequency-induced shrinkage.