The modified Outerbridge grading of chondromalacia is divided into four grades by MRI, typically using fat-saturated proton density sequences. This grading system was originally devised for arthroscopy initially for assessment of chondromalacia patellae, but then modified and extended for all chondral surfaces 1:. grade I. focal areas of hyperintensity with normal contou Classifications in Brief: Outerbridge Classification of Chondral Lesions. Slattery C, Kweon CY. Clin Orthop Relat Res, 476(10):2101-2104, 01 Oct 2018 Cited by: 17 articles | PMID: 29533246 | PMCID: PMC6259817. Review Free to rea Outerbridge Classification System There are several classification systems used to describe chondral lesions and grade cartilage degeneration. However, while it has limitations, one of most popular systems used to grade cartilage degeneration is the Outerbridge classification system. Grade 0: Norma ABSTRACT Objective: To assess the reproducibility of the Outerbridge and the French Society of Arthroscopy classifications between different observers, and to establish a comparison between them. Method: Thirty videos on randomly selected knee arthroscopy procedures demonstrating chondral lesions were used. These were classified by six observers: two third-year orthopedics residents and four. Studies evaluating the reproducibility of hip chondral lesion scores have variable results. Amenabar et al, 3 when evaluating the reproducibility of the Outerbridge, Beck and Haddad classification systems in the diagnosis of arthroscopic chondral lesions, observed interobserver Kappa values of 0.28, 0.33 and 0.47, respectively. The agreement of.
Introduction: Purpose to study prevalence of the intraarticular chondral lesion in the malleolar fracture by using ankle arthroscopy to fully understand the severity and complexity of the injury. Methods: Cross sectional study of 32 patients diagnosed with ankle fracture and undergone open reduction and internal fixation with arthroscopic assessment performed stimultaneously The patellar chondral lesions can be classified as per the size of the lesion, as per the depth of the lesion or as per the location of the lesion. Though sometimes confusing, these classifica-tion systems are crucial in decision making and treatment planning . The Outerbridge classification  grades patellar chondral lesion depending o
ORIGINAL ARTICLE . Assessment of the reproducibility of the Outerbridge and FSA classifications for chondral lesions of the knee . Neylor Pace Lasmar I; Rodrigo Campos Pace Lasmar II; Rodrigo Barreiros Vieira III; Juraci Rosa de Oliveira III; André Campos Scarpa IV. I Head of the Orthopedics and Traumatology Service, São José University Hospital, Minas Gerais School of Medical Sciences. †Outerbridge Classification System of Osteochondral Defects: Grade 0 Normal cartilage Classifications in Brief: Outerbridge Classification of Chondral Lesions. Clin Orthop Relat Res, 476(10):2101-2104. Policy 200714 ~ Page 4 of The interrater reproducibility of the Bern classification seems to have improved in cartilage lesions compared with the Outerbridge classification and in labral lesions compared with the Beck, Peters, and Lage classifications. The Bern classification identified all present cartilage and labral lesions GRADE II/III LESIONS: PARTIAL-THICKNESS CARTILAGE INJURY . Grade II lesions represent fissures, erosion, ulceration, or fibrillation involving the superficial 50% of cartilage thickness. In the modified Outerbridge classification, lesions that extend to the deep 50% of cartilage are considered grade III
7 Classification of Articular Cartilage Injury and Repair BERT R. MANDELBAUM, RALPH A. GAMBARDELLA, AND JASON M. SCOPP The most important issue in the management of articular cartilage disorders is accurate and uniform characterization of the local, regional, systemic, and familial factors. Subjective and objective tools can be used to assess both the lesion an . 6-8 This classification system has been shown as moderately reliable for chondral and hip injuries, with strong intra and interobserver reliability. 2, 9, 10, 15 However, since this classification system was originally. The Outerbridge classification (9) has been widely used to describe articular lesions. Grade 1 represents softening or swelling of the cartilage; Grade 2 is cartilage fibrillation of one half inch diameter or less; Grade 3 is breakdown of greater than one half inch; and Grade 4 is erosion of cartilage down to bone (9) Classifications in brief: Outerbridge classification of chondral lesions. Clin Orthop Relat Res. 2018; 476:2101-2104. [PMC free article] [Google Scholar] 21. LaPrade RF, Wills NJ, Spiridonov SI, Perkinson S. A prospective outcomes study of meniscal allograft transplantation. Am J.
Therefore, terms such as chondropathy and chondral lesion better represent the spectrum of chondral involvement, as mentioned in the article by Krieger et al.(2), published in the previous issue of Radiologia Brasileira. There are several classifications for the assessment of chondral lesions, generally based on size, depth, tissue qual Articular cartilage lesions in weight-bearing joints often fail to heal on their own and may be associated with pain, loss of function and long-term complications such as osteoarthritis. The treatment for chondral injurys ranges from conservative, to arthroscopic and open surgeries (arthroscopic debridement, marrow-stimulating techniques. The modified Noyes grading of chondromalacia was published in 2009 and is divided into four grades by MRI, typically using fat saturated proton density sequences. The original Noyes grading system was based on arthroscopic findings. Classification. grade 0: normal cartilage; grade 1: increased T2 signal intensity of morphologically-normal cartilage not oriented at 55° to the external magnetic. It is essential to have a reliable classification system for chondral lesion seen during surgery in the hip joint. Most classification for chondral lesions are based on classification used in any other joint [27, 28] but lately new classification are being developed to describe various chondral lesions specific to the hip joint [9, 24] Furthermore, there were chondral lesion Grades I-II Classifications in brief: outerbridge classification of chondral lesions, Clinical Orthopaedics and Related Research, vol. 476, no. 10, pp. 2101-2104, 2018. View at: Publisher Site | Google Scholar
. Levy and coworkers have recently confirmed the increasing frequency of isolated chondral injuries in collegiate, professional and world-class soccer players Four fellowship-trained orthopaedic surgeons, with at least 2 years postfellowship experience in hip arthroscopy, independently analyzed the recordings 2 times in randomized order and 4 months apart. They classified the lesions according to the Outerbridge, Beck, and Haddad classifications of chondral damage
Classifications in Brief: Outerbridge Classification of Chondral Lesions. Slattery C, Kweon CY. Clin Orthop Relat Res, 476(10):2101-2104, 01 Oct 2018 Cited by: 6 articles | PMID: 29533246 | PMCID: PMC6259817. Review Free to rea In the study by Widuchowski et al (14), some type of chondral lesion was found in 60% of the knees operated, of which 67% were classified as osteochondral or chondral lesions, 29% as osteoarthritis, 2% as osteochondritis dissecans and 1% as other types. Lesions that were not limited to the cartilage occurred in 70% of the cases, while lesion. For the classification proposed by the French Society of Arthroscopy, the kappa index was .45166.The Outerbridge and French Society of Arthroscopy classifications for chondral lesions are moderately reproducible between observers Thirty nine of these 633 lesions (6.2%) were described as solely chondral lesions according to grade 1 of their corresponding classification [5, 31, 42, 54]. Location of osteochondral lesions Twelve studies reported on the location of the OCLs of which three studies [ 28 , 43 , 51 ] described lesions on the talus, tibial plafond, medial. A loose body is a free-floating piece of bone, cartilage or a foreign object in the knee joint, the most common joint for loose bodies. We will present in this chapter two types of articular loose bodies, the chondral and osteochondral types, different, iatrogenic, loose bodies will be presented in the complications chapter (Fig. 7.8)
Secondly, we identified the sources of poor reliability that may be improved with future disease classification schemes. Our hypothesis was that the Beck classification of labral and chondral lesions would demonstrate substantial reliability, while the differentiation of early forms of disease would be a common source of disagreement The Outerbridge classification system was utilized intraoperatively by the surgeon to visually evaluate chondral damage of the trochlea and patella. Grade 0 corresponded to minimal chondral damage, while grades 1, 2, 3, and 4 represented increasing amounts of chondral damage indicated by examples within the cited publication The objectives of the present study were to evaluate whether synovial shelves of the knee are associated with increased incidence of chondral lesions and to determine which types of plica are associated with significant articular damage. Data were collected prospectively from 1,000 consecutive knee arthroscopies. Of these patients, 321 (32.1%) were found to have synovial shelves of the knee 7 Outerbridge RE. The etiology of chondromalacia patellae. J Bone Joint Surg Br 1961;43-B:752-757. Medline, Google Scholar; 8 Cameron ML, Briggs KK, Steadman JR. Reproducibility and reliability of the Outerbridge classification for grading chondral lesions of the knee arthroscopically. Am J Sports Med 2003;31:83-86. Medline, Google Schola A modification to the Walch classification of the glenoid in primary glenohumeral osteoarthritis using three-dimensional imaging. J shoulder Elb Surg United States. 2016;25:1601-6. Article Google Scholar 15. Slattery C, Kweon CY. Classifications in brief: outerbridge classification of chondral lesions
viii. Normal articular cartilage at the lesion border (contained lesion) ix. For femoral and patellar chondral lesions, absence of a corresponding kissing lesion with a Modified Outerbridge Scale of Grade III or Grade IV of the distal femur (trochlea, condyles), patella or tibia x. Patient has a BMI 35 or less xi. Age 15-55 years g OBJECTIVE To assess the multirater agreement of the modified Outerbridge system for the grading of predefined areas of femorotibial cartilage at CT arthrography with multiple readers, with varying experience. DESIGN Five readers with varying experience (two junior radiologists, three musculoskeletal radiologists including two experts in cartilage imaging) separately analyzed 962 cartilage. However, we could not use a practical and generally accepted classification that defines both features in our clinic. Surface changes Maintaining the habit of defining Outerbridge's popularized cartilage lesions at 4 degrees, we preferred to characterize them topographically as focal, large and kissing lesions. Discussion. Irle et al
Lage classification Class 1 1 2 Class 2 0 1 Class 3 1 5 Class 4 8 2 Outerbridge classification Class 1 1 4 Class 2 4 1 Class 3 2 3 Class 4 3 2 Cam lesions 6 6 Figure 2: Identification of a labral tear (L:labrum; A:acetabulum). Figure 3: Assessment of the femoral head for pathology (F: femoral head; G: gloved hand) The third study by Cameron et al examined 6 cadaveric knees that had undergone diagnos- ACKNOWLEDGMENT tic arthroscopy and subsequent confirmatory arthrotomy.4 The late Dr Sandy Kirkley was an integral member of the Only chondral lesions were graded using the Outerbridge Multicenter Orthopaedic Outcomes Network, and her classification system Chondral Injuries in the Knee F. Alan Barber MD, FACS Key Points Articular cartilage is a smooth, viscoelastic, hypocellular structure that provides a low coefficient of friction. The treatment of articular cartilage injury in the athlete presents several challenges. Most athletes want to return to full activity as soon as possible. Articular cartilage injury in Classifications in Brief: Outerbridge Classification of Chondral Lesions. Slattery, C., Kweon, C. Y.> ;Clinical orthopaedics and related research. 2018 Mar 14 Letter to the Editor: Editorial: Do Orthopaedic Surgeons Belong on the Sidelines at American Football Games METHODS: We carried out a controlled retrospective study of 30 patients affected by a post-traumatic hip chondropathy of the third or fourth degree, according to the Outerbridge classification, measuring 2 cm² in area or more. Of these patients, 15 underwent arthroscopic ACT, whereas the other 15 underwent arthroscopic debridement
Patellar dislocation is strongly associated with damage to the articular surface, with chondral defects of the patella seen in up to 95% of patients ; the incidence of OCD is estimated at 30 to 60 cases per 100,000 people. Several large studies have found high-grade chondral lesions (Outerbridge grade III and IV) in 5% to 11% of younger. Patients with Outerbridge grade I and grade II were included in this study. Outbridge grade I chondral lesion is defined as swelling and softening of articular surface that can be assessed with a probe during arthroscopy. Outbridge grade II lesion is defined as a chondral lesion with partial thickness defect of less than half inch diameter Background:Degenerative medial meniscus posterior root tears (MMPRTs) are reportedly associated with medial compartment osteoarthritis and meniscal extrusion with a displaced gap from the root inse.. Lysholm knee scale: - originally designed to assess ligament injuries of the knee but later has been used to asses chondral injuries of the knee; - measure that contains 8 domains: limp, locking, pain, stair-climbing, support, instability, swelling, and squatting; - score of 0 to 100 is calculated: - 95 to 100 indicates an excellent result Posterior malleolus fractures can occur as a result of the following mechanisms 2,3: supination and adduction. supination and external rotation. pronation and external rotation or abduction. They are seen in the context of medial malleolar and infrasyndesmotic, transsyndesmotic or suprasyndesmotic fibular injuries
Arthroscopy is considered as the gold standard for the diagnosis of traumatic intraarticular knee lesions. However, recent developments in magnetic resonance imaging (MRI) now offer good opportunities for the indirect assessment of the integrity and structural changes of the knee articular cartilage. The study was to investigate whether cartilage-specific sequences on a 3-Tesla MRI. The hip is the third most common joint affected by osteoarthritis after the knee and the hand 1. Women are more commonly affected than men. Reported prevalence varies in different studies and is also subject to geographic conditions. The lifetime risk of symptomatic hip osteoarthritis in people reaching the age of 85 years was estimated to be. Patients with Outerbridge grade III or IV cartilage lesions localized in the medial or lateral condyle of the knee (Chondral lesions were diagnosed by magnetic resonance T2 mapping and graded according to the Outerbridge classification.). Size of lesion between 1.5 cm2 and 6 cm2 (specify size, alignment, and telemetry) Body mass index ≤ 30 kg/m2 Seventy percent of the anterior, 27% of the superior, and 36% of the posterior chondral injuries were grade III or IV by Outerbridge criteria.2 In addition, the senior author's classification of labral tears demonstrates a clear decrement in outcome once an associated chondral acetabular lesion of greater than 1 cm occurs.3 (See Chapter 12. chondral lesions in 60% of the cases, of which 24% were grade III and 12% grade IV, based on the Outerbridge classification [2, 3]. A similar classification system was used by Curl et al. regarding 31,516 knee arthroscopies. Articular cartilage damage was reported in 63% of patients, of which 60% were grade III and IV . Articular chondral.
In 1961, Outerbridge (28) described a grading system for articular damage that was based on his findings with open operative procedures for patellar chondromalacia. This system was based on the size and gross appearance of surface lesions and did not include factors such as lesion depth or location or associated pathology on other joint surfaces Chondral lesions are common and several classification systems exist to classify them based on severity, location, radiographic parameters, and potential treatment options. When working up a patient with a potential hip chondral lesion, a complete history, thorough physical exam, and ancillary imaging are necessary 13.1 Grading of chondromalacia according to Outerbridge  Outerbridge described in 1961 the macroscopic aspect of changes of the articular cartilage for the articular surface of the patella. Meanwhile this classification is generally used for the description of articular cartilage lesions
chondral lesion was found in 60% of the knees ope-rated, of which 67% were classified as osteochondral or chondral lesions, 29% as osteoarthritis, 2% as oste-ochondritis dissecans and 1% as other types. Lesions that were not limited to the cartilage occurred in 70% of the cases, while lesion thus limited accounted for 30% In patients who underwent surgical repair for MMPRTs, factors such as Outerbridge grade 3 or 4 chondral lesions, pre-existing osteoarthritis with K-L grade >3, definite meniscal degeneration, and higher body mass index (>30 kg/m 2) were associated with poor clinical outcomes. 16,17,23,27,29 When considering treatment options for MMPRTs in. Reproducibility and reliability of the Outerbridge classification for grading chondral lesions of the knee arthroscopically. Am J Sports Med 2003; 31 (01) 83-86 ; 11 Outerbridge RE. The etiology of chondromalacia patellae. J Bone Joint Surg Br 1961; 43-B: 752-757 ; 12 Outerbridge RE, Dunlop JA. The problem of chondromalacia patellae. Clin. Acetabular cartilage lesions are frequently found during hip arthroscopy. The arthroscopic view offers an exceptional perspective to assess cartilage injuries especially in their early stages. We know that articular cartilage damage occurs progressively up to the development of hip osteoarthritis requiring joint replacement. Numerous studies have shown that advanced cartilage damage is an. Classification of cartilage lesions Although there are a number of classifications for assess-ing the degree of joint cartilage damage, the most wide-ly used option is the classification of Outerbridge (1961), which defines four grades(5,6) (Figure 3): • Grade I: softening or edema of the cartilage surface
Chondral lesions were left unaltered for patients in the CL-noDeb group. Patients without unstable chondral lesions were included in the nonrandomized no chondral lesion (NoCL) group and did not require surgical management of chondral lesions. An intra-articular injection of 20 mL of 0.5% bupivacaine was administered at the end of the procedure what are 3 types of pre-arthritic lesions? chondral injury, osteochondral fracture/injury, osteochondritis dissicans what is the leading causes of loose bodies in a joint, and can start off as osteochondral lesions or fractur
and chondral defects; however, au-thors have also observed the positive association between age and surgical delay, which likely contributes to this finding.5,9 However, in studies that specifically evaluate grades of chondral defects, older patients, on average, have higher-grade lesions than younger patients.3,5,10 Male Chondral lesions were noted in 26 of 36 patients. The most commonly affected place was the talar dome. Twenty of 26 ankles had outerbridge grades III to IV chondral lesions. Ten of 26 ankles had two or more sites of chondral lesions. The size of the chondral lesions that were larger than 0.5 cm × 0.5 cm was found in 17 of 26 ankles studied All patients had Outerbridge grade 3 or 4 lesions of the acetabulum. Three patients had Outerbridge grade 4 lesions of the femoral head. At an average follow-up of 3 years, 50% of the patients had undergone or were scheduled for THA. The authors concluded that hip arthroscopy for FAI is contraindicated in patients with Tönnis grade 3 OA. 3 Outerbridge is the most used chondral lesion classification system although delamination was not originally described it could be considered as a Type III. Konan et al . [ 4 ] recently described a new classification system for hip chondral lesions, including the wave sign, delamination and chondrolabral lesions considering extension and location The Outerbridge Classification is a system that has been developed for judging articular cartilage injury to the knee. This system allows delineation of varying areas of chondral pathology, based on the qualitative appearance of the cartilage surface as viewed by direct visualization intraoperatively, and can assist in identifying thos
Knee symptomatic chondral lesion of grade III/IV (according to Outerbridge Classification) or osteochondral lesion; Not re-fixable OCD lesions; Lesion between 2-9 cm2; Single lesion; Patients agreed to actively participate in the rehabilitation protocol and follow-up program; Male or female patients Widuchowski retrospectively analysed 25,124 arthroscopies Cartilage lesions were classified in accordance with the Outerbridge classification. Chondral lesions were found in 60% of the patients. Documented cartilage lesions were localized in 67%, osteoarthritis in 29%, osteochondritis dissecans in 2% and other types in 1% Basics in hip chondrolabral lesions and state of the art. Mohamed Abd El-Radi1, Oliver R. Marin-Peña2*, Hatem Galal Said1 and Marc Tey-Pons3. 1 Orthopedic Surgery and Traumatology, University Hospital Assuit, Assiut, Egypt. 2 Orthopedic Surgery and Traumatology, University Hospital Infanta Leonor, Madrid, Spain
Moreover, common findings, such as chondral debonding or articular cleavage, flaps and delamination are absent from Outerbridge classification . Amenabar et al. [ 12 ] believes that lower reliability of Outerbridge in describing hip joint pathology, as opposed to previous reports in the knee, is attributed to the unique anatomy of the. .6%), while in 270 cases (54%) we found one or more cm ) in the medial or lateral condyle. grade I or II chondral lesions in various articular sites (e) Autologous. For the classification proposed by the French Society of Arthroscopy, the kappa index was 0.45166. Conclusion: The Outerbridge and French Society of Arthroscopy classifications for chondral lesions are moderately reproducible between observers
always easily fit into a chondral lesion grad-ing system. If there is superficial cartilage in-jury, the modified Outerbridge classification would usually be grade 3 (i.e., deep ulceration or a chondral flap involving 50% or more of the depth of the articular cartilage without ex-posure of subchondral bone) or grade 4 (i.e., exposed bone) [15. Modified Outerbridge Classification is a system that has been developed for judging articular cartilage injury to the knee. This system allows delineation of varying areas of chondral pathology, based on the qualitative appearance of the cartilage surface and can assist in identifying those injuries that are suitable for repair techniques
treatment of chondral lesions in the hip with the AMIC technique. Material and methods Between 2008 and 2014, 201 patients over 583 treat-ed with hip arthroscopy, underwent an AMIC proce - dure for the treatment of grade III and/or IV acetabu - lar chondral lesions, according to the Outerbridge classification 13 .All these 201 patients included. Articular cartilage lesions is a collective term for injuries where the articular cartilage of the knee joint is affected, such as chondromalacia, tears in the articular cartilage, etc. They occur in patients of varying ages. Articular cartilage lesions in weight-bearing joints often fail to heal on their own and may be associated with pain, loss of function and long-term complications such as.
Classification of Articular Cartilage Lesions by Severity Grade Outerbridge 0 . Normal cartilage . I ; and mosaicplasty are two types of osteochondral autografting: single-institution case series focusing on chondral lesions of the knee. In addition, there are very few studies currently availabl Hamada Fukuda Classification for Cuff tear Arthropathy. In 1977, Neer and colleagues were the first to describe the term cuff tear arthropathy (CTA). This term, however, refers only to end-stage changes associated with massive rotator cuff tears when collapse of the subchondral bone of the humeral head and advanced arthritis are present Unique Protocol ID: ORT-12 : Brief Title: Study for the Treatment of Knee Chondral and Osteochondral Lesions : Official Title: Multicenter Randomized Controlled Trial for the Treatment of Knee Chondral and Osteochondral Lesions: Marrow Stimulation Techniques vs MaioRege An Observational, Prospective, Multicentre Study of Patients With Outerbridge Grade III / IV Chondral and/or Osteochondral Defects of the Knee Treated With Nanofractured Autologous Matrix-induced Chondrogenesis. Analyze clinical trials with filters and metrics. Efficiently skim through many trials at a time
9) In many cases, more severe chondral lesions were inspected at the medial femoral condyle, so the medial femoral condyle was selected as the main lesions. At the time of arthroscopy, a 5-mm graduated probe was used to assess the size of each lesion. At least 2 crossed diagonal measurements were used. The Outerbridge classification According to the arthroscopic system of classification of chondral injury proposed by Bauer and Jackson , delamination injuries are either flap or crater types. The modified ICRS classification categorizes delamination injuries as ICRS grade 3b or 3d lesions, depending on the status of the superficial cartilage [ 10 ]
Society (ICRS) classifications. The articular surface was divided into 6 regions. Based on MRI findings, of the 288 articular surface evaluations, 113 (39%) surface evaluations were classified as disease-positive (grade 2 to 4). Kappa interrater reli-ability scores for MRI evaluation, Outerbridge classification, and ICRS classification The Modified Outerbridge Classification is a system that has been developed for judging articular cartilage injury to the knee. This system allows delineation of varying areas of chondral pathology, based on the qualitative appearance of the cartilage surface, and can assist in identifying those injuries that are suitable for repair techniques evaluation is the Outerbridge classification,33 but this scale also has a wide range of inter-observer reliability.34-37 Cameron,38 in a cadaver-based study, concluded: The Outerbridge classification was moderately accurate when used to grade chondral lesions arthroscopically. Brismar,39 in a videotape study, concluded: Th UPDATING ARTICLE . Updating on diagnosis and treatment of chondrallesion of the knee . Marcantonio Machado da Cunha Cavalcanti Filho I; Daniel Doca II; Moisés Cohen III; Mário Ferretti IV. I Intern of the Locomotor Program of the Hospital Israelita Albert Einstein (HIAE) - São Paulo, SP, Brazil II Assistant Physician of the Sports Traumatology Center (CETE) of the Department of.
When isolating the articular grading to the senior author on MRI evaluation vs Outerbridge classification, the sensitivity, specificity, and accuracy were 54%, 92%, and 75%, respectively. Based on the current findings, 3.0-T MRI is as an invaluable noninvasive tool with good diagnostic value for assessing articular cartilage lesions of the knee. lesion was graded based on the Outerbridge classification. Severity of chondral pathology was divided into two groups: Low graded groups (type 1 and 2) and high grade groups (type 3 and 4). The data gathered from 616 athletes were entered . and then analyzed using SPSS.  Chi‑square test was used to evaluate the correlation between the. Grading: (Outerbridge classification) grade 0 - normal. grade 1 - cartilage signal abnormality, but appears architecturally intact. grade 2 - surface fraying or focal defects involving less than 50% of cartilage thickness. grade 3 - defects involving more than 50% of cartilage thickness, without bone oedem