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Arthroscopic lavage

'Lavage' means 'washing'. To lavage a joint means to wash out any blood, fluid or loose debris from inside the joint space.

Lavage is generally combined with arthroscopic debridement, where fronds of joint material or degenerative tissue is sucked out using a small ‘hoover’ - ie. both washing (rinsing) and sucking. ‘Arthroscopic’ means that this is done using keyhole surgery, where a thin ‘scope’ is pushed into the joint (arthro=joint) to visualise the structures.

Excessive growth of irritated synovium leads it to multiply its surface area by buckling into fronds, and the fronds may become inflamed and pour destructive enzymes into the joint space, leading to joint swelling and joint surface destruction. ‘Hoovering’ away this excessive material (debridement), and washing out any debris (lavage), frequently settles down an irritable knee.

Joint cartilage restoration

Arthroscopic lavage is a minor part of an armamentarium of procedures which are now available to help reverse the damage of early arthritis:

• lavage, debridement
• abrasion arthroplasty, sub chondral drilling, microfracture
• osteochondral allograft and autograft (OATS procedure, mosaicplasty, paste grafting)
• autologous chondrocyte implantation (ACI or MACI) or transplantation (ACT)

There is, however, controversy about the value of simple lavage and debridement for the older patient with established osteoarthritis.