A retrospective study was performed examining 84 patients who had undergone arthroscopic debridement for high-grade osteoarthritis of the knee joint. After an average follow-up period of 52 (35-72) months only 14 (16.7%) patients indicated an improvement of the preoperative situation. 36 (42.8%) patients had severe joint pain after one year postoperatively. 17 (24.3%) patients were evaluated with 85-100 points and 53 (75.7%) patients with less than 85 points in a modified Lysholm-score. There were better results in younger patients (< 50 years). Compared with the literature, aggressive subchondral abrasion does not show any benefits. Patients' preoperative expectations have to be clearly objectified. With this prerequisite the surgical procedure as an operation with low complication risk can also be justified as a temporary alternative to total knee arthroplasty in patients suffering from a high-grade degeneration of the knee joint.