Arthroscopy: The Journal of Arthroscopic & Related Surgery
Original ArticleKnee Chondral Lesions: Incidence and Correlation Between Arthroscopic and Magnetic Resonance Findings
Section snippets
Methods
Between March 2003 and February 2004, 250 knee arthroscopic procedures were performed in the same hospital by 2 surgeons with 15 years of experience in knee surgery.
Excluding patients without a preoperative MRI, 190 patients were eligible for this study (116 males and 74 females), with an average age of 34.8 years (range, 14 to 79 years). MRI was performed in a 1.5-Tesla GE machine (GE Medical Systems, Milwaukee, WI), with proton density, T1, and T2 sequences in axial, coronal, and sagittal
Results
During arthroscopic surgery, 82 out of 190 knees (43.16%) had at least 1 chondral lesion (ICRS classification 1 or more), represented by 40 women and 42 men with an average age of 41.12 years (14 to 79 years, standard deviation = 16.51). We found a total of 115 lesions in 82 knees. Single lesions accounted for 72% of all the defects (Table 2).
Regarding their location, chondral lesions showed a predilection for the medial femoral condyle (32.2%), the medial articular surface of the patellae
Discussion
Our study confirms that cartilage defects are common findings in patients with knee symptoms with an indication of arthroscopic surgery. This has been previously stated by other authors in large series of patients: Curl et al.2 found 63% of cartilage defects in 31,516 patients of which 19% were Outerbridge IV lesions.2 Hjelle et al.3 reported 61% of chondral or osteochondral lesions in 1,000 consecutive arthroscopies. We found 43.6% of lesions in 190 arthroscopies, the majority of which were
Conclusions
Knee arthroscopy is a useful method for the evaluation of chondral lesions and is more accurate than MRI in the diagnosis of these injuries. Although unenhanced MRI using a 1.5-Tesla magnet with conventional sequences (proton density-weighted, T1-weighted, and T2-weighted) is most accurate at revealing deeper lesions and defects at the patellae, our study shows that a considerable number of lesions will remain undetected until arthroscopy, which remains the gold standard.
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The authors report no conflict of interest.