Abstract
Purpose: We report a new method of describing and recording chondral lesions of the knee at
arthroscopy in order to permit a more accurate and meaningful analysis of patterns
of articular cartilage damage. Type of Study: Case series study. Methods: Data were collected prospectively at 1,000 consecutive arthroscopies by the senior
author and chondral lesions were recorded on anatomic articular maps divided into
different functional zones. Ten zones on the femur were determined by tibiofemoral
weight-bearing and flexion horizons (namely the 0°, 45°, 90°, and 120° horizons as
they pass the anterior meniscosynovial junction). Ten zones were determined on the
tibia, principally by meniscal relations, and 6 zones on the patella. This allowed
the size, Outerbridge grade, and location to be analyzed in relation to mechanism,
chronicity, and associated intra-articular pathologies. The recording methods were
tested for interobserver reproducibility in 50 subsequent cases at the same arthroscopy
by 2 independent observers. The results were analyzed by a third person, and showed
a relatively small interobserver error of 7.2% for size for a set of grade 3 and 4
lesions and only a 3% error for site. The Fisher exact test was used. The data sheets
were entered onto a computer spreadsheet database using standard software (Excel;
Microsoft, Redmond, WA) to permit analysis of the data. Results: There were 1,553 chondral lesions in 853 patients correlated with associated lesions,
including 356 meniscal lesions, 230 ligamentous injuries, 440 synovial lesions, and
other pathologies. High degrees of correlation have been found between specific lesions
and their opposing surfaces and the progression of these with time. Conclusions: The problem of precision of localization of articular lesions in the knee has been
recently acknowledged by the International Cartilage Research Society (ICRS). However,
such recording ought to take into account both function and contact with other structures.
This would appear essential in the assessment of prognosis and comparisons between
different treatment regimes.
Arthroscopy: The Journal of Arthroscopic and Related Surgery, Vol 17, No 5 (May-June),
2001: pp 481–490
Keywords
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Article info
Footnotes
*Address correspondence and reprint requests to Jordi Sanchez-Ballester, F.R.C.S.(Edin), 32 Brooklands, Horwich, Bolton, BL6 5RW Greater Manchester, England. E-Mail: [email protected]
Identification
Copyright
© 2001 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
