Extract
Injuries to joint surfaces can result from acute high-impact or repetitive
shear and torsional loads to the superficial zone of the articular cartilage
architecture. Direct arthroscopic visualization has suggested that the
prevalence of isolated, focal articular cartilage defects is approximately
5%1,2.
In a retrospective review of more than 31,000 arthroscopic procedures, Curl et
al. found a 63% prevalence of chondral lesions with an average of 2.7 lesions
per knee1. Older
patients had more lesions. Curl et al. found grade-IV lesions (according to a
modification of the Outerbridge classification
system3) in 20% of
the patients, but only 5% of the individuals who had such a lesion were less
than forty years old. Three out of four of the patients had a solitary lesion.
A prospective study demonstrated chondral or osteochondral lesions in 61% of
the patients, whereas focal defects were found in
19%2; these
percentages are similar to those found in the retrospective
analysis1. In the
prospective assessment, the mean defect size was 2.1 cm2. A single,
well-defined International Cartilage Repair Society (ICRS) grade-III or IV
defect4 (at least 1
cm2) accounted for 5.3%, 6.1%, and 7.1% of the arthroscopic
procedures in patients younger than forty, forty-five, and fifty years old,
respectively2. The
prevalence of articular lesions secondary to work-related and sports
activities has been reported to be as high as 22% to 50% in other
studies5,6.
Such injuries alone or in combination with ligamentous instability, meniscal
lesions, or mechanical malalignment can be debilitating.