Results of arthroscopic joint debridement in different stages of chondromalacia of the knee joint

A retrospective study was performed of 161 patients who had undergone arthr oscopic operation for chondromalacia of the knee joint. After an average fo llow-up period of 40 (range 10-72) months, patients with severe articular c artilage lesions who had undergone articular lavage alone showed significan tly poorer results (P < 0.001). With the same stage of chondromalacia and h aving undergone the same surgical procedure, younger patients showed better results than older patients. The more effective interruption of the circul us vitiosus during the development of degenerative joint diseases is the pr imary cause for better results achieved by mechanical debridement of the jo int for patients suffering from grade 2 or higher. According to the literat ure, aggressive subchondral abrasion in severely degenerated knees does not show any benefits. Apparently, the success of the therapy depends to a gre at extent on the inferiority of the potential degenerative regenerate (lack of capacity of intrinsic regeneration of the hyaline cartilage) as well as on the grade and the progression of chondromalacia. Almost every second pa tient suffering from grade 4 chondromalacia complained of recurrent pain 1 year postoperatively. One of every 6 patients received a knee joint prosthe sis within the Ist year Therefore, the patients' preoperative expectations have to be clearly objectified. The surgical procedure as an operation with a low complication risk can also be justified as a temporary alternative t o total knee arthroplasty in patients suffering from a high-grade degenerat ion of the joint.