Arthroscopic abrasion arthroplasty historical and pathologic perspective: present status.

Arthroscopic abrasion arthroplasty is a modification of open Magnusson "housecleaning" arthroplasty. The arthroscopic approach decreases incision size enhancing postoperative rehabilitation. Arthroscopic techniques enhance the accuracy of diagnosis and provide accuracy of limiting debridement only to diseased tissue in various other dimensions of arthroplasty. The abrasion of a sclerotic lesion superficially removes dead bone, exposes vascularity providing a tissue bed for blood clot attachment. Postoperative joint protection provides an environment for clot organization and fibrous tissue formation. Subsequent fibrocartilage formation has maintained integrity for up to 6 years, the extent of experience. The clinical indication is pain. The patient benefit, therefore, is also subjective. Objective evidence of healing response is demonstrated by second-look arthroscopy, biopsy, and comparison x-ray films. If nothing else, these clinical and pathological observations have challenged "established concepts" and opened new vistas for investigation.