Today, it is a widespread practice to try all conservative (non-surgical) methods in the management of the symptoms of knee osteoarthritis. When the non-surgical treatment options fail, the orthopedist must recommend surgery. The arthroscopic washout is a valid surgical treatment option, but under strict conditions and with the right indications.
What Is An Arthroscopic Washout?
An arthroscopic washout involves the use of the arthroscope – a special micro camera that sends the image to a screen – and specialized surgical tools to remove degenerated cartilage or bone. The surgeon usually performs a thorough rinsing of the joint to remove any intra-articular debris or “loose bodies”. Arthroscopic washout a few years ago was more common for all those patients who did not benefit from conservative therapy. Today it is still a therapeutic choice based on the correct indications.
EFFICIENCY OF ARTHROSCOPIC WASHOUT
Several theories have been proposed in the past to explain the mechanism of action of an arthroscopic washout. According to some studies, the removal of the synovial fluid along with all the inflammatory enzymes, as well as some residues from the affected knee is enough to relieve the patient.
According to other studies, the improvement in symptomatology is due to the removal of degenerated cartilage, small pieces or fragments of the meniscus and inflammatory elements, etc. However, an arthroscopic washout does not alter the natural progression of osteoarthritis, but it does have an effect on the symptoms it causes. This is a minimally invasive procedure that is aimed at patients with moderate grade of osteoarthritic lesions, who have tried all conservative therapeutic methods (anti-inflammatory drugs, physiotherapy, intra-articular injections).
An arthroscopic washout provides a relatively short-term relief of symptoms without particular intervention in the underlying pathology. For this reason only a selected group of patients with the expectation of short-term symptom relief could benefit from the additional advantage of low morbidity associated with this method. For patients with higher requirements and expectations for long-term recovery and improvement, the Orthopedist should recommend surgery with unicompartmental or total knee arthroplasty, as appropriate.