Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 19, Issue 10, pp 1699–1703 | Cite as

Interactions between severity and location of chondral lesions and meniscal tears found at arthroscopy

  • S. Jones
  • N. Caplan
  • A. St Clair Gibson
  • N. Kader
  • D. Kader



This study reports the specific interactions between the different grades and locations of chondral lesions found in symptomatic knees requiring arthroscopy. The associations between meniscal tears and chondral lesions were also investigated.


Data were analysed for 141 knee arthroscopies (87 males and 54 females), with a mean patient age of 45.9 years. Chondral lesions were defined according to the modified Outerbridge classification system by a single surgeon immediately following arthroscopic surgery.


The most common clinical findings were medial meniscal tears (47%) and medial femoral condyle lesions (57%). Compared to other locations within the knee, the medial femoral condyle was the most commonly affected location for a chondral lesion and 75% of these lesions were graded as III (32%) or IV (43%). Similarly, 77% of knees with a trochlea lesion were affected by high-grade chondral lesions (grade III = 12%; grade IV = 65%). The trochlea presented with the greatest percentage of grade IV chondral lesions. Eighty percent of patients with a meniscal tear also had a chondral lesion. Medial meniscal tears were most commonly observed with medial femoral condyle lesion. Lateral meniscal tears were most commonly observed with lateral tibial plateau lesions. Twenty-nine percent of patients had corresponding lesions on the medial femoral condyle and medial tibial plateau, and this was the most commonly found interaction between chondral lesion locations.


Patients with medial meniscal tears are likely to also have a chondral lesion on the same side of the knee.

Level of evidence



Meniscal Chondral Tear Lesion Arthroscopy Outerbridge 


  1. 1.
    Arøen A, Løken S, Heir S, Alvik E, Ekeland A, Granlund OG, Engebretsen L (2004) Articular cartilage lesions in 993 consecutive knee arthroscopies. Am J Sports Med 32:211–215PubMedCrossRefGoogle Scholar
  2. 2.
    Asseki D, Özcan Ö, Bya H, Pinar H (2004) A new weight-bearing meniscal test a comparison with McMurray’s test and joint line tenderness. Arthroscopy 9:951–958Google Scholar
  3. 3.
    Bronstein RD (2002) Meniscal tears: current treatment options. Curr Opin Orthop 13:143–150CrossRefGoogle Scholar
  4. 4.
    Brittberg M, Winalski CS (2009) Evaluation of cartilage injuries and repair. J Bone Joint Surg 85:58–69Google Scholar
  5. 5.
    Christoforakis JJ, Strachan RK (2005) Internal derangements of the knee associated with patellofemoral joint degeneration. Knee Surg Sports Traumatol Arthrosc 13:581–584PubMedCrossRefGoogle Scholar
  6. 6.
    Curl WW, Krome J, Gordon S, Rushing J, Smith BP, Poehling GG (1997) Cartilage injuries: a review of 31,516 knee arthroscopies. Arthroscopy 13:456–460PubMedCrossRefGoogle Scholar
  7. 7.
    Englund M, Guermazi A, Gale D, Hunter DJ (2008) Incidental meniscal findings on knee MRI in middle aged and elderly persons. N Eng J Med 359:1108CrossRefGoogle Scholar
  8. 8.
    Farr J (2004) Patellofemoral articular cartilage treatment. In: Fulkerson JP (ed) Common patellofemoral problems. American Academy of Orthopaedic Surgeons, Rosemont, pp 85–99Google Scholar
  9. 9.
    Freeman MAR, Pinskerova V (2005) The movement of the normal movement of the tibio-femoral joint. J Biomech 38:197–208PubMedCrossRefGoogle Scholar
  10. 10.
    Figueroa D, Calvo R, Vaisman A, Carrasco MA, Moraga C, Delgado I (2007) Knee chondral lesions: incidence and correlation between arthroscopic and magnetic resonance findings. Arthroscopy 23:312–315PubMedCrossRefGoogle Scholar
  11. 11.
    Gallo RA, Feeley BT (2009) Cartilage defects of the femoral trochlea. Knee Surg Sports Traumatol Arthrosc 17:1316–1325PubMedCrossRefGoogle Scholar
  12. 12.
    Gommoll AH, Minas T, Farr J, Cole BJ (2006) Treatment of chondral defects in the patellofemoral joint. J Knee Surg 19:285–295Google Scholar
  13. 13.
    Habata T, Uemastu K, Hattori K, Takaura Y, Fujisawa Y (2004) Clinical feature of the posterior horn tear in the medial meniscus. Arch Orthop Trauma Surg 124:642–645PubMedCrossRefGoogle Scholar
  14. 14.
    Hjelle K, Solheim E, Strand T, Muri R, Brittberg M (2002) Articular cartilage defects in 1,000 knee arthroscopies. Arthroscopy 18:730–734PubMedCrossRefGoogle Scholar
  15. 15.
    Hunt N, Sanchez-Ballester J, Pandit R, Thomas R, Strachan R (2001) Chondral lesions of the knee: a new localization method and correlation with pathology. Arthroscopy 17:481–490PubMedCrossRefGoogle Scholar
  16. 16.
    Johal P, Williams A, Wragg P, Hunt D, Gedroyc W (2005) Tibio-femoral movement in the living knee. A study of weight bearing and non-weight bearing knee kinematics using “interventional” MRI. J Biomech 38:269–276PubMedCrossRefGoogle Scholar
  17. 17.
    Mandelbaum BR, Browne JE, Fu F, Micheli L, Mosely JB, Erggelet C, Minas T, Peterson L (1998) Articular cartilage lesions of the knee. Am J Sports Med 25:486–494Google Scholar
  18. 18.
    Messer K, Jizong G (1998) The menisci of the knee joint. Anatomical and functional characteristics, and rationale for clinical treatment. J Anat 193:161–178CrossRefGoogle Scholar
  19. 19.
    Morelli M, Nagamori J, Miniaci A (2002) Articular lesions in the knee: evaluation and treatment options. Curr Opin Orthop 13:155–161CrossRefGoogle Scholar
  20. 20.
    Outerbridge RE (1997) The etiology of chondromalcia patella. Arthroscopy 13:456–460CrossRefGoogle Scholar
  21. 21.
    Rath E, Richmond JC (2000) The menisci: basic science and advances in treatment. Br J Sports Med 34:252–257PubMedCrossRefGoogle Scholar
  22. 22.
    Rose REC (2006) The accuracy of joint line tenderness in the diagnosis of meniscal tears. West Indian Med J 55:323–326PubMedGoogle Scholar
  23. 23.
    Shah MR, Kaplan KM, Meislin RJ, Bosco JA (2007) Articular cartilage restoration of the knee. Bull NYU Hosp Jt Dis 65:51–60PubMedGoogle Scholar
  24. 24.
    Slauterbeck JR, Kousa P, Blake C, Clifton C, Naud S, Tourville TW, Johnson RJ, Beynnon BD (2009) Geographic mapping of meniscus and cartilage lesions associated with anterior cruciate ligament injuries. J Bone Joint Surg Am 91:2094–2103PubMedCrossRefGoogle Scholar
  25. 25.
    Tandogan RN, Taser Ö, Kayaalp A, Taskiran E, Pinar H, Alparslan B, Alturfan A (2004) Analysis of meniscal and chondral lesions accompanying anterior cruciate ligament tears: relationship with age, time from injury and level of sport. Knee Surg Sport Traumatol Arthosc 12:262–270CrossRefGoogle Scholar
  26. 26.
    Van Den Bekerom MPJ, Patt TW, Rutten S, Raven S, Van De Vis HMV, Albers RGH (2007) Arthroscopic debridement for grade III and IV chondromalacia of the knee in patients older than 60 years. J Knee Surg 20:271–276PubMedGoogle Scholar
  27. 27.
    Widuchowski W, Widuchowski J, Trzaska T (2007) Articular cartilage defects: study of 25, 124 knee arthroscopies. Knee 14:177–182PubMedCrossRefGoogle Scholar
  28. 28.
    Zamber RW, Teitz CC, McGuire DA et al (1989) Articular cartilage lesions of the knee. Arthroscopy 5:258–268PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • S. Jones
    • 1
    • 2
    • 3
  • N. Caplan
    • 1
    • 3
  • A. St Clair Gibson
    • 1
    • 3
  • N. Kader
    • 1
  • D. Kader
    • 1
    • 2
    • 3
  1. 1.North East Orthopaedic and Sports Injury Research GroupTyne and WearUK
  2. 2.Department of OrthopaedicsQueen Elizabeth HospitalSherriff Hill, GatesheadUK
  3. 3.School of Life SciencesNorthumbria UniversityNewcastle upon TyneUK

Personalised recommendations