Question: What is debridement or lavage (via arthroscopic surgery) and when is it best used to treat pain resulting from osteoarthritis?
Answer: Arthroscopic debridement for osteoarthritis of either the hip or the knee is performed with some frequency in the United States. In general, you're looking at earlier stage of the disease where the knee is not severely arthritic or the hip is not severely arthritic. Once severe arthritis occurs, you're looking at more replacement options than you are retention options, or arthroscopic debridement type options.
Arthroscopic debridement is best performed in the knee when there are mechanical symptoms. And what I mean by that is that there's locking, catching or giving way in the knee and that the alignment of the knee is reasonable. You're not terribly bow-legged and you're not terribly knock-kneed.
Under those conditions the results are fairly reasonable both with arthroscopic treatment of knee arthritis as well as arthroscopic treatment of hip arthritis. In the hip usually you're looking at debriding something called the labrum. In the knee you're typically looking at debriding something called the meniscus. In both cases, removing that mechanical impairment can sometimes result in significant pain relief and delay the need for either hip replacement or knee replacement surgery.