Knee Surgery, Sports Traumatology, Arthroscopy

, Volume 24, Issue 6, pp 1753–1762 | Cite as

Early osteoarthritis of the knee

  • Henning MadryEmail author
  • Elizaveta Kon
  • Vincenzo Condello
  • Giuseppe M. Peretti
  • Matthias Steinwachs
  • Romain Seil
  • Massimo Berruto
  • Lars Engebretsen
  • Giuseppe Filardo
  • Peter Angele


There is an increasing awareness on the importance in identifying early phases of the degenerative processes in knee osteoarthritis (OA), the crucial period of the disease when there might still be the possibility to initiate treatments preventing its progression. Early OA may show a diffuse and ill-defined involvement, but also originate in the cartilage surrounding a focal lesion, thus necessitating a separate assessment of these two entities. Early OA can be considered to include a maximal involvement of 50 % of the cartilage thickness based on the macroscopic ICRS classification, reflecting an OARSI grade 4. The purpose of this paper was to provide an updated review of the current status of the diagnosis and definition of early knee OA, including the clinical, radiographical, histological, MRI, and arthroscopic definitions and biomarkers. Based on current evidence, practical classification criteria are presented. As new insights and technologies become available, they will further evolve to better define and treat early knee OA.

Level of evidence IV.


OA Pain Osteochondral unit Cartilage Subchondral bone Meniscus Traumatic lesion Classification Focal cartilage defect Biomarkers 


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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2016

Authors and Affiliations

  • Henning Madry
    • 1
    • 2
    Email author
  • Elizaveta Kon
    • 3
  • Vincenzo Condello
    • 4
  • Giuseppe M. Peretti
    • 5
    • 6
  • Matthias Steinwachs
    • 7
  • Romain Seil
    • 8
  • Massimo Berruto
    • 9
  • Lars Engebretsen
    • 10
  • Giuseppe Filardo
    • 11
  • Peter Angele
    • 12
    • 13
  1. 1.Center of Experimental OrthopaedicsSaarland UniversityHomburg/SaarGermany
  2. 2.Department of Orthopaedic SurgerySaarland University Medical CenterHomburg/SaarGermany
  3. 3.NABI LaboratoryRizzoli Orthopaedic InstituteBolognaItaly
  4. 4.Dipartimento di Ortopedia, Responsabile di Struttura Semplice di Traumatologia dello, Sport Knee Surgery and Sports TraumatologyOspedale Sacro Cuore - Don CalabriaNegrar, VeronaItaly
  5. 5.IRCCS Istituto Ortopedico GaleazziMilanItaly
  6. 6.Department of Biomedical Sciences for HealthUniversity of MilanMilanItaly
  7. 7.SportClinic ZürichKlinik HirslandenZurichSwitzerland
  8. 8.Service de Chirurgie Orthopédique, Centre de L‘Appareil Locomoteur, de Médecine du Sport et de Prévention, Centre Hospitalier de Luxembourg-Clinique d’Eich and Sports Medicine Research LaboratoryLuxembourg Institute of HealthLuxembourgLuxembourg
  9. 9.Centro di Eccellenza per L’attività Ortopedica, Reumatologica e RiabilitativaL’Istituto Ortopedico Gaetano Pini è un’Azienda Ospedaliera di rilievo nazionaleMilanItaly
  10. 10.Department of Orthopedic SurgeryOslo University Hospital and Oslo Sports Trauma Research CenterOsloNorway
  11. 11.Biomechanics Laboratory, II Orthopaedics and Traumatology ClinicRizzoli Orthopaedic InstituteBolognaItaly
  12. 12.Department of Trauma SurgeryUniversity Medical Center RegensburgRegensburgGermany
  13. 13.Sporthopaedicum RegensburgRegensburgGermany

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