Articular Cartilage Lesions of the Knee
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Clinically Relevant Anatomy
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Articular cartilage which covers the ends of bones in joints.
The knee is the most common place for articular cartilage lesions.
Mechanism of Injury / Pathological Process
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Most articular cartilage defects are caused by trauma. This can either be one single impact injury or repeated micro trauma. A specific group of cartilage damage is 'osteochondritis dissecans' where a well-demarcated small area of cartilage and underlying bone loses its blood supply, dies and eventually fragments and separates into the joint.
Grades of articular cartilage lesions and criteria for choosing appropriate therapy
The Outerbridge scale:
Grade 0: intact articular cartilage
Grade 1: cartilage softening, intact joint surface, focal colour change
Grade 2: superficial fissuring
Grade 3: fissures and fragmentation extending into the matrix
Grade 4: erosion reaching the subchondral bone plate. Eburnated bone
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Injuries to the cartilage can be partial thickness (part of the way down to bone) or full-thickness (all the way down to bone).
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