Chondrectomy--Review of Surgical Instrumentation and its Effectiveness.

UNLABELLED ΒACKGROUND: To present surgical instrumentation used in knee chondrectomy and evaluate its effectiveness - a review of the literature. Surgical removal of joint cartilage, or chondrectomy, has been performed by orthopedists since the 1950s. Initially carried out as an open surgery, it has generally come to be performed arthroscopically. Its aim is to create even and stable cartilaginous edges perpendicular to the joint surface and a suitably prepared bottom of the defect for optimum integration of the cartilaginous regenerate. MATERIAL AND METHODS In order to present surgical instrumentation used in knee chondrectomy, English-language journals from the years 2010-2013 with an Impact Factor (2013) of at least 2.0 were analyzed. Papers concerning effectiveness and precision of knee chondrectomy according to the instrument used were also analyzed. RESULTS According to the articles the most popular instruments used to debride chondral defects are open bone curettes (67% of the surgeries), scalpels (35%) and shavers (21%). Open bone curettes were used most frequently in open surgeries (78%), often along with scalpels (49% of the surgeries). In arthroscopic procedures, the most common instruments were shavers (50% of the surgeries) and open bone curettes (49%). CONCLUSIONS 1. In open chondrectomies, the most frequently used instruments are open bone curettes and scalpels. 2. Of all instrumentation presented in this review, this combination ensures the highest precision, as required by Steadman's criteria, of debriding the edges and bottom of a chondral defect. 3. In arthroscopic procedure, a shaver and an open bone curette is the most frequently used combination. 4. None of the instruments and their combinations used in arthroscopic procedure ensures debridement of the defect in compliance with Steadman's recommendations.