Abrasion arthroplasty

The word 'arthroplasty' means 'reshaping of the joint'. 'Abrasion' means to 'grind down'. So an abrasion arthroplasty is a surgical procedure to reshape the joint by grinding down the damaged surface.

This is usually performed with a rotating burr, removing rough bits and also allowing blood and bone marrow cells to come to the surface and form a better joint surface covering.

The technique is used for the management of early arthritis of the joint cartilage, where the surgeon abrades the damaged surface down to bleeding bone, removing any softened or loose bits, and also any osteophytes (bone spurs). The philosophy is that blood vessels will nourish the damaged area and primitive blood cells will reform into joint cartilage cells and cover the damaged area with a new healthy surface. It is usually kept for smaller areas, as it has been found that the material which grows ('fibrocartilage') is not as strong as proper cartilage and may either break down or grow somewhat exuberantly.

You need to note that different surgeons use the term abrasion arthroplasty somewhat differently. Some will use it even if they have only just rubbed down small areas of joint cartilage, while other surgeons reserve the term for a fairly radical re-modelling of the damaged joint surface.

Abrasion arthroplasty is part of an armamentarium of cartilage regeneration procedures that are now available to help reverse the damage of early arthritis:

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

Other relevant resources on this site:

• Surgical cartilage repair for knee arthritis
• Articular cartilage repair by Dr Karen Hambly
• Biologic Knee Replacement by Dr Kevin Stone