Debridement of Articular Cartilage: The Natural Course

Chondral defects of the knee are quite common, affecting an estimated 10% to 12% of the population. Symptomatic chondral defects are thought to be persistent and possibly progressive. Less is known about the natural history of asymptomatic chondral lesions. Traditional treatment of chondral lesions has involved arthroscopic debridement with a mechanical shaver. Radiofrequency chondroplasty has been explored as a possible alternative or adjuvant to mechanical chondroplasty. The role of chondroplasty in the setting of knee osteoarthritis is more controversial. Early studies demonstrated promising results of arthroscopic debridement in the context of knee arthritis. However, publications in the last 10 to 15 years have brought into question the role of arthroscopic debridement in the setting of knee osteoarthritis. The purpose of this chapter is to explore the role of arthroscopic debridement in the treatment of chondral defects.