Classification of Chondral and Osteochondral Injuries of the Knee : Wheeless' Textbook of Orthopaedics

- See:
- Knee Joint Menu:
- Arthroscopy of the Degenerative Knee
- Osteochondritis Dessicans
- Osteoarthritis

- Discussion:
- described types articular cartilage lesions;
- mild lesion, w/ normal appearing cartilage - it is difficult to dissern borders of lesion and normal surrounding cartilage.
- mild fibrillation, discoloration, cartilage softer than normal;
- linear crack: usually split thickness, and often encountered on lateral tibial plateau in assoc w/ anterior cruciate injuries;
- stellate: most common;
- diverging w/ central flaking of the cartilage;
- flap tear: the carilage is avulsed from the subchondral bone;
- partial thickness w/ fibrillation;
- crater: full thickness, in which subchondral bone is exposed;
- degrading lesion: cartilage is degenerative in nature and extends down to subchondral bone;
- Outerbridge classification:
- grade 0: normal cartilage;
- grade I: cartilage with softening and swelling;
- grade II: a partial-thickness defect with fissures on the surface that do not reach subchondral bone or exceed 1.5 cm in diameter;
- grade III: fissuring to the level of subchondral bone in an area with a diameter more than 1.5 cm;
- grade IV, exposed subchondral bone.
- Lysholm knee scale:
- originally designed to assess ligament injuries of the knee but later has been used to asses chondral injuries of the knee;
- outcome measure that contains 8 domains: limp, locking, pain, stair-climbing, support, instability, swelling, and squatting;
- score of 0 to 100 is calculated:
- 95 to 100 indicates an excellent result;
- 84 to 94 indicates a good result;
- 65 to 83 indicates a fair result;
- less than 65 indicates a poor result