Arthroscopic Chondroplasty

Cartilage lesions of the knee are a common pathology found in up to 60% of patients undergoing knee arthroscopy. The prevalence of cartilage lesions is particularly high among athletes due to the increased physiologic and mechanical demands they face. Cartilage lesions can result from traumatic injuries or chronic knee pathologies. The associated symptoms can help to localize the lesion, and magnetic resonance imaging is the best imaging modality for visualizing and confirming cartilage defects. Treatment choice for cartilage lesions depends on the size of the defect, location, involvement of subchondral bone, and concomitant injuries. Chondroplasty is the treatment of choice for small cartilage lesions (

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References

  1. Widuchowski W, Widuchowski J, Trzaska T. Articular cartilage defects: study of 25,124 knee arthroscopies. Knee. 2007;14(3):177–82. https://doi.org/10.1016/j.knee.2007.02.001. ArticleCASPubMedGoogle Scholar
  2. Steinwachs MR, Engebretsen L, Brophy RH. Scientific evidence base for cartilage injury and repair in the athlete. Cartilage. 2012;3(1 Suppl) https://doi.org/10.1177/1947603511415841.
  3. Totlis T, Marín Fermín T, Kalifis G, Terzidis I, Maffulli N, Papakostas E. Arthroscopic debridement for focal articular cartilage lesions of the knee: A systematic review. Surgeon. 2021;19(6):356–64. https://doi.org/10.1016/j.surge.2020.11.011. ArticlePubMedGoogle Scholar
  4. Anderson DE, Rose MB, Wille AJ, Wiedrick J, Crawford DC. Arthroscopic mechanical chondroplasty of the knee is beneficial for treatment of focal cartilage lesions in the absence of concurrent pathology. Orthop J Sports Med. 2017;5(5):1–8. https://doi.org/10.1177/2325967117707213. ArticleGoogle Scholar
  5. Sofat N, Ejindu V, Kiely P. What makes osteoarthritis painful? The evidence for local and central pain processing. Rheumatology. 2011;50(12):2157–65. https://doi.org/10.1093/rheumatology/ker283. ArticlePubMedGoogle Scholar
  6. Falah M, Nierenberg G, Soudry M, Hayden M, Volpin G. Treatment of articular cartilage lesions of the knee. Int Orthop. 2010;34(5):621–30. https://doi.org/10.1007/s00264-010-0959-y. ArticlePubMedPubMed CentralGoogle Scholar
  7. Eliasberg CD, Strickland SM. Meniscus and articular cartilage injuries. In: The female athlete; 2022. https://doi.org/10.1016/b978-0-323-75985-4.00001-5. ChapterGoogle Scholar
  8. Alonso B, Bravo B, Mediavilla L, et al. Osteoarthritis-related biomarkers profile in chronic anterior cruciate ligament injured knee. Knee. 2020;27(1):51–60. https://doi.org/10.1016/j.knee.2019.12.007. ArticlePubMedGoogle Scholar
  9. Bigoni M, Sacerdote P, Turati M, et al. Acute and late changes in intraarticular cytokine levels following anterior cruciate ligament injury. J Orthop Res. 2013;31(2):315–21. https://doi.org/10.1002/jor.22208. ArticleCASPubMedGoogle Scholar
  10. DeFroda SF, Bokshan SL, Yang DS, Daniels AH, Owens BD. Trends in the surgical treatment of articular cartilage lesions in the United States from 2007 to 2016. J Knee Surg. 2021;34(14) https://doi.org/10.1055/s-0040-1712946.
  11. Yanke AB, Cole BJ. Joint preservation of the knee: a clinical casebook; 2019. https://doi.org/10.1007/978-3-030-01491-9. BookGoogle Scholar
  12. Miller MD, Browne JA, Cole BJ, Cosgarea AJ, Owens BD. Operative techniques: knee Surgery; 2018. Google Scholar
  13. McKeon BP, Bono JV, Richmond JC. Knee arthroscopy. Knee Arthroscopy. Published online. 2009:1–202. https://doi.org/10.1007/978-0-387-89504-8.
  14. PalmerJS PA. Cochrane library Cochrane database of systematic reviews surgical interventions for symptomatic mild to moderate knee osteoarthritis (review). Published online. 2019; https://doi.org/10.1002/14651858.CD012128.pub2.
  15. Krych AJ, Saris DBF, Stuart MJ, Hacken B. Cartilage injury in the knee: assessment and treatment options. J Am Acad Orthop Surg. 2020;28(22):914–22. https://doi.org/10.5435/JAAOS-D-20-00266. ArticlePubMedGoogle Scholar
  16. Cavanaugh JT, Sgaglione NA. Rehabilitation after articular cartilage repair: chondroplasty, abrasion arthroplasty, and microfracture. In: Postsurgical orthopedic sports rehabilitation; 2006. https://doi.org/10.1016/B978-032302702-1.50023-5. ChapterGoogle Scholar
  17. Cichanowski HR, Chambers CC. Patellofemoral pain in the female athlete. In: The female athlete; 2022. https://doi.org/10.1016/b978-0-323-75985-4.00017-9. ChapterGoogle Scholar
  18. Salem HS, Chaudhry ZS, Lucenti L, Tucker BS, Freedman KB. The importance of staging arthroscopy for chondral defects of the knee. J Knee Surg. 2022;35(02) https://doi.org/10.1055/s-0040-1713126.
  19. Kirkley A, Birmingham TB, Litchfield RB, et al. A randomized trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med. 2008;359(11) https://doi.org/10.1056/nejmoa0708333.
  20. Moseley JB, O’Malley K, Petersen NJ, Menke TJ, Brody BA, Kuykendall DH, Hollingsworth JC, Ashton CM, Wray NP. A controlled trial of arthroscopic surgery for osteoarthritis of the knee. N Engl J Med. 2002;347(2):81–8. ArticlePubMedGoogle Scholar
  21. Day B. The indications for arthroscopic debridement for osteoarthritis of the knee. Orthop Clin N Am. 2005;36(4):413–7. ArticleGoogle Scholar
  22. Spahn G, Mückley T, Kahl E, Hofmann GO. Factors affecting the outcome of arthroscopy in medial-compartment osteoarthritis of the knee. Arthroscopy. 2006;22(11) https://doi.org/10.1016/j.arthro.2006.07.003.
  23. Widuchowski W, Widuchowski J, Koczy B, Szyluk K. Untreated asymptomatic deep cartilage lesions associated with anterior cruciate ligament injury: results at 10- and 15-year follow-up. Am J Sports Med. 2009;37(4) https://doi.org/10.1177/0363546508328104.
  24. Shelbourne KD, Jari S, Gray T. Outcome of untreated traumatic articular cartilage defects of the knee: A natural history study. J Bone Joint Surg Am. 2003;85 https://doi.org/10.2106/00004623-200300002-00002.
  25. Bisson LJ, Kluczynski MA, Wind WM, et al. Observation versus debridement of unstable chondral lesions during partial meniscectomy. J Bone Joint Surg. 2021;103(17):1569–77. https://doi.org/10.2106/jbjs.20.01582. ArticlePubMedGoogle Scholar
  26. Merchan ECR, Galindo E. Arthroscope-guided surgery versus nonoperative treatment for limited degenerative osteoarthritis of the femorotibial joint in patients over 50 years of age: A prospective comparative study. Arthroscopy. 1993;9(6) https://doi.org/10.1016/S0749-8063(05)80503-1.
  27. Mandelbaum BR, Browne JE, Fu F, Micheli L, Mosely JB, Erggelet C, Minas T, Peterson L. Articular cartilage lesions of the knee. Am J Sports Med. 1998;26(6):853–61. ArticleCASPubMedGoogle Scholar
  28. Mithöfer K, Peterson L, Mandelbaum BR, Minas T. Articular cartilage repair in soccer players with autologous chondrocyte transplantation: functional outcome and return to competition. Am J Sports Med. 2005;33(11) https://doi.org/10.1177/0363546505275647.
  29. Miller, Mark; Cole, Brian; Cosgarea, Andrew; Sekiya J. Operative techniques: sports knee surgery. 2017. Google Scholar
  30. Ward BD, Lubowitz JH. Basic knee arthroscopy part 4: chondroplasty, meniscectomy, and cruciate ligament evaluation. Arthrosc Tech. 2013;2(4) https://doi.org/10.1016/j.eats.2013.07.011.
  31. Horton D, Anderson S, Hope NG. A review of current concepts in radiofrequency chondroplasty. ANZ J Surg. 2014;84(6):412–6. https://doi.org/10.1111/ans.12130. ArticlePubMedGoogle Scholar
  32. Anderson SR, Faucett SC, Flanigan DC, Gmabardella RA, Amin NH. The history of radiofrequency energy and Coblation in arthroscopy: a current concepts review of its application in chondroplasty of the knee. J Exp Orthop. 2019;6(1):1–7. https://doi.org/10.1186/s40634-018-0168-y. ArticleCASPubMedPubMed CentralGoogle Scholar
  33. Spahn G, Kahl E, Mückley T, Hofmann GO, Klinger HM. Arthroscopic knee chondroplasty using a bipolar radiofrequency-based device compared to mechanical shaver: results of a prospective, randomized, controlled study. Knee Surg Sports Traumatol Arthrosc. 2008;16:565–73. https://doi.org/10.1007/s00167-008-0506-1. ArticlePubMedGoogle Scholar
  34. Spahn G, Klinger HM, McKley T, Hofmann GO. Four-year results from a randomized controlled study of knee chondroplasty with concomitant medial meniscectomy: mechanical debridement versus radiofrequency chondroplasty. Arthroscopy. 2010;26(9 SUPPL. 1):S73–80. https://doi.org/10.1016/j.arthro.2010.02.030. ArticlePubMedGoogle Scholar
  35. Koller U, Springer B, Rentenberger C. et al, Radiofrequency chondroplasty may not have a long-lasting effect in the treatment of concomitant grade II Patellar Cartilage defects in humans. Clin Med. https://doi.org/10.3390/jcm9041202.
  36. Bhatia S, Hsu A, Lin EC, et al. Surgical treatment options for the young and active middle-aged patient with Glenohumeral arthritis. Adv Orthop. 2012;2012 https://doi.org/10.1155/2012/846843.
  37. Angermann P, Harager K, Tobin L. Arthroscopic chondrectomy as a treatment of cartilage lesions. Knee Surg Sports Traumatol Arthrosc. 2002;10(1):6–9. ArticleCASPubMedGoogle Scholar
  38. Federico DJ, Reider B. Results of isolated patellar debridement for patellofemoral pain in patients with normal pateliar alignment. Am J Sports Med. 1997;25(5) https://doi.org/10.1177/036354659702500513.
  39. Hubbard MJS. Articular debridement versus washout for degeneration of the medial femoral condyle: A five-year study. J Bone Joint Surg Br. 1996;78(2) https://doi.org/10.1302/0301-620x.78b2.0780217.
  40. Flanigan DC, Harris JD, Trinh TQ, Siston RA, Brophy RH. Prevalence of chondral defects in athletes’ knees: a systematic review. Med Sci Sports Exerc. 2010;42(10):1795–801. https://doi.org/10.1249/MSS.0b013e3181d9eea0. ArticlePubMedGoogle Scholar
  41. Levy AS, Lohnes J, Sculley S, LeCroy M, Garrett W. Chondral delamination of the knee in soccer players. Am J Sports Med. 1996;24(5) https://doi.org/10.1177/036354659602400512.
  42. Scillia AJ, Aune KT, Andrachuk JS, et al. Return to play after chondroplasty of the knee in national football league athletes. Am J Sports Med. 2015;43(3) https://doi.org/10.1177/0363546514562752.

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  1. Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky, Lexington, KY, USA Breanna Sullivan, Jeffrey Bannister, Holly Stilz & Austin V. Stone
  1. Breanna Sullivan
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  1. Sports Medicine Clinic, Stanford University, Redwood City, CA, USA Seth L. Sherman
  2. Midwest Orthopedics, Rush University, Chicago, IL, USA Jorge Chahla
  3. Department of Orthopedics, Hospital for Special Surgery, New York, NY, USA Scott A. Rodeo
  4. Complex Knee and Sports Medicine Surgeon, Twin Cities Spine Center, Edina, MN, USA Robert LaPrade

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  1. University of Colorado, Denver, USA Rachel Frank
  2. University of Missouri, Missouri, USA Clayton Nuelle

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Sullivan, B., Bannister, J., Stilz, H., Stone, A.V. (2024). Arthroscopic Chondroplasty. In: Sherman, S.L., Chahla, J., Rodeo, S.A., LaPrade, R. (eds) Knee Arthroscopy and Knee Preservation Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-82869-1_16-1

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