Abrasive or Abrasion Chondroplasty
During this procedure the cartilage and bone sustain a trauma with ensuing therapeutic bleeding from subchondral bone space. The benefit of this procedure stems from the fact that the blood clot would trigger a spontaneous formation of the fibrous tissue with a number of the components of the cartilage. The drawbacks of this procedure are the irreproducibility and unreliability (at least in the animal studies). There are some suggestions that if the appropriate physical therapy treatment follows the operation, the quality of the fibrous cartilage could be improved.
The operation can be done as an open surgery on the manner of the Magnuson debridement "house cleaning" operation, or it can be done arthroscopically. This image from an arthroscopic operation shows a mechanical burr literally mowing away the unstable and undermined cartilage of the knee joint
Image Credit: CLINICAL ORTHOPAEDICS AND RELATED RESEARCH
Number 391S, pp. S306–S317This procedure does lower the incidence of pain over 12 months. However after 2 years after the procedure there was no difference in clinical outcome between people who had the treatment.
The picture below is a radiograph of the same knee before abrasion chondroplasty (A) and 2 years after (B). It is possible to see that the post operational knee is in overall better shape with fibula better aligned in the joint and there is not as much contact between the bones. This illustrates the fact that the outcomes of the abrasion chondroplasty are unpredictable.
Image credit: CLINICAL ORTHOPAEDICS AND RELATED RESEARCH
Number 391S, pp. S306–S317
