Arthroscopic debridement comprises the removal of dead tissue, bone chips or other unwanted material and/or the smoothing of intrusive bone during arthroscopic surgery on a joint. The debris is suctioned out or washed away with saline solution in a process called lavage. The point of the whole procedure is to clean out the joint to make more room for movement required by the remaining healthy bones and tissue.
An arthroscopic surgery is a relatively minor outpatient procedure that can address an acute, destabilizing injury to the joint — such as a torn ligament — or relieve chronic pain caused by displaced cartilage or rough bone. The primary purpose of arthroscopic surgery for serious, sudden injuries usually is the repair of or realignment of parts of the joint, with debridement as a secondary procedure. When the problem is chronic pain such as that engendered by arthritis, however, the scope of the surgery generally is limited to arthroscopic debridement.
Although the procedure is performed most frequently on the knee, arthroscopic debridement can be useful in relieving pain in other major joints of the body, such as the shoulder, elbow, ankle, wrist or hip. Typically working in a triangular array, the surgeon makes three small cuts around the knee, one of which is for the arthroscope, a flexible, fiber-optic tube with a tiny lighted camera that transmits a view of the joint to a video monitor. The arthroscope itself might have other tools on it, including those used in joint debridement.
The other incisions give the surgeon flexibility during the surgery, which can also serve an exploratory purpose regarding the specific conditions in the joint. For example, while operating on a patient with a torn meniscus — a common injury to the crescent of cartilage that cushions the knee — the surgeon might discover that there is not enough healthy tissue to make a repair. An alternative would be to trim the tissue, or debride it, so that it will not get pinched between the two bones.
Acute injuries to a joint most often are caused by accidents, sports or activities involving overuse, and chronic pain frequently occurs because of osteoarthritis or rheumatoid arthritis. This condition, also known as degenerative joint disease, results from bony spurs and cysts that develop as a joint loses cartilage. Medical professionals do not routinely consider arthroscopic debridement to be the first option for treating joint pain from arthritis, because promising medications and effective rehabilitation alternatives have been developed and because, in practice, not all patients are helped by surgery.