Skip to main content

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

Knee Surgery, Sports Traumatology, Arthroscopy volume 19, pages 1699–1703 (2011)Cite this article

Abstract

Purpose

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.

Methods

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.

Results

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.

Conclusion

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

Level of evidence

II.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

References

  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 32:211–215

    PubMed  Article  Google Scholar 

  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 9:951–958

    Google Scholar 

  3. Bronstein RD (2002) Meniscal tears: current treatment options. Curr Opin Orthop 13:143–150

    Article  Google Scholar 

  4. Brittberg M, Winalski CS (2009) Evaluation of cartilage injuries and repair. J Bone Joint Surg 85:58–69

    Google Scholar 

  5. Christoforakis JJ, Strachan RK (2005) Internal derangements of the knee associated with patellofemoral joint degeneration. Knee Surg Sports Traumatol Arthrosc 13:581–584

    PubMed  Article  Google Scholar 

  6. Curl WW, Krome J, Gordon S, Rushing J, Smith BP, Poehling GG (1997) Cartilage injuries: a review of 31,516 knee arthroscopies. Arthroscopy 13:456–460

    PubMed  Article  CAS  Google Scholar 

  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 359:1108

    Article  CAS  Google Scholar 

  8. Farr J (2004) Patellofemoral articular cartilage treatment. In: Fulkerson JP (ed) Common patellofemoral problems. American Academy of Orthopaedic Surgeons, Rosemont, pp 85–99

    Google Scholar 

  9. Freeman MAR, Pinskerova V (2005) The movement of the normal movement of the tibio-femoral joint. J Biomech 38:197–208

    PubMed  Article  CAS  Google Scholar 

  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 23:312–315

    PubMed  Article  Google Scholar 

  11. Gallo RA, Feeley BT (2009) Cartilage defects of the femoral trochlea. Knee Surg Sports Traumatol Arthrosc 17:1316–1325

    PubMed  Article  Google Scholar 

  12. Gommoll AH, Minas T, Farr J, Cole BJ (2006) Treatment of chondral defects in the patellofemoral joint. J Knee Surg 19:285–295

    Google Scholar 

  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 124:642–645

    PubMed  Article  CAS  Google Scholar 

  14. Hjelle K, Solheim E, Strand T, Muri R, Brittberg M (2002) Articular cartilage defects in 1,000 knee arthroscopies. Arthroscopy 18:730–734

    PubMed  Article  Google Scholar 

  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 17:481–490

    PubMed  Article  CAS  Google Scholar 

  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 38:269–276

    PubMed  Article  CAS  Google Scholar 

  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 25:486–494

    Google Scholar 

  18. Messer K, Jizong G (1998) The menisci of the knee joint. Anatomical and functional characteristics, and rationale for clinical treatment. J Anat 193:161–178

    Article  Google Scholar 

  19. Morelli M, Nagamori J, Miniaci A (2002) Articular lesions in the knee: evaluation and treatment options. Curr Opin Orthop 13:155–161

    Article  Google Scholar 

  20. Outerbridge RE (1997) The etiology of chondromalcia patella. Arthroscopy 13:456–460

    Article  Google Scholar 

  21. Rath E, Richmond JC (2000) The menisci: basic science and advances in treatment. Br J Sports Med 34:252–257

    PubMed  Article  CAS  Google Scholar 

  22. Rose REC (2006) The accuracy of joint line tenderness in the diagnosis of meniscal tears. West Indian Med J 55:323–326

    PubMed  CAS  Google Scholar 

  23. Shah MR, Kaplan KM, Meislin RJ, Bosco JA (2007) Articular cartilage restoration of the knee. Bull NYU Hosp Jt Dis 65:51–60

    PubMed  Google Scholar 

  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 91:2094–2103

    PubMed  Article  Google Scholar 

  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 12:262–270

    Article  Google Scholar 

  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 20:271–276

    PubMed  Google Scholar 

  27. Widuchowski W, Widuchowski J, Trzaska T (2007) Articular cartilage defects: study of 25, 124 knee arthroscopies. Knee 14:177–182

    PubMed  Article  CAS  Google Scholar 

  28. Zamber RW, Teitz CC, McGuire DA et al (1989) Articular cartilage lesions of the knee. Arthroscopy 5:258–268

    PubMed  Article  CAS  Google Scholar 

Download references

Author information

Affiliations

  1. North East Orthopaedic and Sports Injury Research Group, Tyne and Wear, UK

    S. Jones, N. Caplan, A. St Clair Gibson, N. Kader & D. Kader

  2. Department of Orthopaedics, Queen Elizabeth Hospital, Sherriff Hill, Gateshead, NE9 6SX, UK

    S. Jones & D. Kader

  3. School of Life Sciences, Northumbria University, Newcastle upon Tyne, UK

    S. Jones, N. Caplan, A. St Clair Gibson & D. Kader

Authors
  1. S. Jones
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. N. Caplan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. A. St Clair Gibson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N. Kader
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. D. Kader
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D. Kader.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Jones, S., Caplan, N., St Clair Gibson, A. et al. Interactions between severity and location of chondral lesions and meniscal tears found at arthroscopy. Knee Surg Sports Traumatol Arthrosc 19, 1699–1703 (2011). https://doi.org/10.1007/s00167-011-1470-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-011-1470-8

Keywords

  • Meniscal
  • Chondral
  • Tear
  • Lesion
  • Arthroscopy
  • Outerbridge