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Chondral Injury, Knee
Andrew Sonin, MD, FACR; Donna G. Blankenbaker, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Synonyms

              • Cartilage fracture, cartilage tear, cartilage defect, chondral flap, chondral fissure, chondral defect, delamination
            • Definitions

              • Injury to hyaline cartilage surfaces in knee joint sparing underlying bone

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • Staging, Grading, & Classification

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Image Interpretation Pearls

                                        • Reporting Tips

                                          Selected References

                                          1. Alizai H et al: An update on risk factors for cartilage loss in knee osteoarthritis assessed using MRI-based semiquantitative grading methods. Eur Radiol. 25(3):883-93, 2015
                                          2. Oussedik S et al: Treatment of articular cartilage lesions of the knee by microfracture or autologous chondrocyte implantation: a systematic review. Arthroscopy. 31(4):732-744, 2015
                                          3. Alizai H et al: Cartilage lesion score: comparison of a quantitative assessment score with established semiquantitative MR scoring systems. Radiology. 271(2):479-87, 2014
                                          4. Kijowski R et al: Quantitative magnetic resonance imaging of the articular cartilage of the knee joint. Magn Reson Imaging Clin N Am. 22(4):649-69, 2014
                                          5. Markhardt BK et al: Hypointense signal lesions of the articular cartilage: a review of current concepts. Clin Imaging. 38(6):785-91, 2014
                                          6. Stephens T et al: The cartilage black line sign: an unexpected MRI appearance of deep cartilage fissuring in three patients. Skeletal Radiol. 40(1):113-6, 2011
                                          7. Van Assche D et al: Autologous chondrocyte implantation versus microfracture for knee cartilage injury: a prospective randomized trial, with 2-year follow-up. Knee Surg Sports Traumatol Arthrosc. 18(4):486-95, 2010
                                          8. Black BR et al: Cartilage imaging in sports medicine. Sports Med Arthrosc. 17(1):68-80, 2009
                                          9. Gobbi A et al: Biological approaches for cartilage repair. J Knee Surg. 22(1):36-44, 2009
                                          10. Gold GE et al: Recent advances in MRI of articular cartilage. AJR Am J Roentgenol. 193(3):628-38, 2009
                                          11. Kon E et al: Arthroscopic second-generation autologous chondrocyte implantation compared with microfracture for chondral lesions of the knee: prospective nonrandomized study at 5 years. Am J Sports Med. 37(1):33-41, 2009
                                          12. Levine DW et al: Characterized chondrocyte implantation results in better structural repair when treating symptomatic cartilage defects of the knee in a randomized controlled trial versus microfracture. Am J Sports Med. 37(3):e3; author reply e4, 2009
                                          13. Mathieu L et al: Knee MR-arthrography in assessment of meniscal and chondral lesions. Orthop Traumatol Surg Res. 95(1):40-7, 2009
                                          14. Mithoefer K et al: Clinical efficacy of the microfracture technique for articular cartilage repair in the knee: an evidence-based systematic analysis. Am J Sports Med. 37(10):2053-63, 2009
                                          15. Tohyama H et al: Atelocollagen-associated autologous chondrocyte implantation for the repair of chondral defects of the knee: a prospective multicenter clinical trial in Japan. J Orthop Sci. 14(5):579-88, 2009
                                          16. Trattnig S et al: MR imaging of cartilage and its repair in the knee--a review. Eur Radiol. 19(7):1582-94, 2009
                                          17. Gaissmaier C et al: Growth and differentiation factors for cartilage healing and repair. Injury. 39 Suppl 1:S88-96, 2008
                                          18. Hettrich CM et al: Cartilage repair: third-generation cell-based technologies--basic science, surgical techniques, clinical outcomes. Sports Med Arthrosc. 16(4):230-5, 2008
                                          19. Kon E et al: Second generation issues in cartilage repair. Sports Med Arthrosc. 16(4):221-9, 2008
                                          20. McNickle AG et al: Overview of existing cartilage repair technology. Sports Med Arthrosc. 16(4):196-201, 2008
                                          21. Pelttari K et al: The use of mesenchymal stem cells for chondrogenesis. Injury. 39 Suppl 1:S58-65, 2008
                                          22. Williams III RJ et al: Cartilage repair procedures: clinical approach and decision making. Instr Course Lect. 57:553-61, 2008
                                          23. Hennig A et al: Osteochondral allografts in the treatment of articular cartilage injuries of the knee. Sports Med Arthrosc. 15(3):126-32, 2007
                                          24. Noyes FR et al: A system for grading articular cartilage lesions at arthroscopy. Am J Sports Med. 17(4):505-13, 1989
                                          25. Outerbridge RE et al: The problem of chondromalacia patellae. Clin Orthop Relat Res. (110):177-96, 1975
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Pathology

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Synonyms

                                                      • Cartilage fracture, cartilage tear, cartilage defect, chondral flap, chondral fissure, chondral defect, delamination
                                                    • Definitions

                                                      • Injury to hyaline cartilage surfaces in knee joint sparing underlying bone

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • CT Findings

                                                          • MR Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • Staging, Grading, & Classification

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Image Interpretation Pearls

                                                                                • Reporting Tips

                                                                                  Selected References

                                                                                  1. Alizai H et al: An update on risk factors for cartilage loss in knee osteoarthritis assessed using MRI-based semiquantitative grading methods. Eur Radiol. 25(3):883-93, 2015
                                                                                  2. Oussedik S et al: Treatment of articular cartilage lesions of the knee by microfracture or autologous chondrocyte implantation: a systematic review. Arthroscopy. 31(4):732-744, 2015
                                                                                  3. Alizai H et al: Cartilage lesion score: comparison of a quantitative assessment score with established semiquantitative MR scoring systems. Radiology. 271(2):479-87, 2014
                                                                                  4. Kijowski R et al: Quantitative magnetic resonance imaging of the articular cartilage of the knee joint. Magn Reson Imaging Clin N Am. 22(4):649-69, 2014
                                                                                  5. Markhardt BK et al: Hypointense signal lesions of the articular cartilage: a review of current concepts. Clin Imaging. 38(6):785-91, 2014
                                                                                  6. Stephens T et al: The cartilage black line sign: an unexpected MRI appearance of deep cartilage fissuring in three patients. Skeletal Radiol. 40(1):113-6, 2011
                                                                                  7. Van Assche D et al: Autologous chondrocyte implantation versus microfracture for knee cartilage injury: a prospective randomized trial, with 2-year follow-up. Knee Surg Sports Traumatol Arthrosc. 18(4):486-95, 2010
                                                                                  8. Black BR et al: Cartilage imaging in sports medicine. Sports Med Arthrosc. 17(1):68-80, 2009
                                                                                  9. Gobbi A et al: Biological approaches for cartilage repair. J Knee Surg. 22(1):36-44, 2009
                                                                                  10. Gold GE et al: Recent advances in MRI of articular cartilage. AJR Am J Roentgenol. 193(3):628-38, 2009
                                                                                  11. Kon E et al: Arthroscopic second-generation autologous chondrocyte implantation compared with microfracture for chondral lesions of the knee: prospective nonrandomized study at 5 years. Am J Sports Med. 37(1):33-41, 2009
                                                                                  12. Levine DW et al: Characterized chondrocyte implantation results in better structural repair when treating symptomatic cartilage defects of the knee in a randomized controlled trial versus microfracture. Am J Sports Med. 37(3):e3; author reply e4, 2009
                                                                                  13. Mathieu L et al: Knee MR-arthrography in assessment of meniscal and chondral lesions. Orthop Traumatol Surg Res. 95(1):40-7, 2009
                                                                                  14. Mithoefer K et al: Clinical efficacy of the microfracture technique for articular cartilage repair in the knee: an evidence-based systematic analysis. Am J Sports Med. 37(10):2053-63, 2009
                                                                                  15. Tohyama H et al: Atelocollagen-associated autologous chondrocyte implantation for the repair of chondral defects of the knee: a prospective multicenter clinical trial in Japan. J Orthop Sci. 14(5):579-88, 2009
                                                                                  16. Trattnig S et al: MR imaging of cartilage and its repair in the knee--a review. Eur Radiol. 19(7):1582-94, 2009
                                                                                  17. Gaissmaier C et al: Growth and differentiation factors for cartilage healing and repair. Injury. 39 Suppl 1:S88-96, 2008
                                                                                  18. Hettrich CM et al: Cartilage repair: third-generation cell-based technologies--basic science, surgical techniques, clinical outcomes. Sports Med Arthrosc. 16(4):230-5, 2008
                                                                                  19. Kon E et al: Second generation issues in cartilage repair. Sports Med Arthrosc. 16(4):221-9, 2008
                                                                                  20. McNickle AG et al: Overview of existing cartilage repair technology. Sports Med Arthrosc. 16(4):196-201, 2008
                                                                                  21. Pelttari K et al: The use of mesenchymal stem cells for chondrogenesis. Injury. 39 Suppl 1:S58-65, 2008
                                                                                  22. Williams III RJ et al: Cartilage repair procedures: clinical approach and decision making. Instr Course Lect. 57:553-61, 2008
                                                                                  23. Hennig A et al: Osteochondral allografts in the treatment of articular cartilage injuries of the knee. Sports Med Arthrosc. 15(3):126-32, 2007
                                                                                  24. Noyes FR et al: A system for grading articular cartilage lesions at arthroscopy. Am J Sports Med. 17(4):505-13, 1989
                                                                                  25. Outerbridge RE et al: The problem of chondromalacia patellae. Clin Orthop Relat Res. (110):177-96, 1975