The language of cartilage: why Outerbridge still matters

Cartilage lesions are a common source of joint dysfunction, often progressing to osteoarthritis. Although magnetic resonance imaging (MRI) has advanced significantly in recent years, providing detailed non-invasive evaluation, arthroscopy remains the gold standard for assessing cartilage integrity. Effective clinical communication between radiologists and orthopedic surgeons relies heavily on simple and clear grading systems. Numerous cartilage grading schemes have emerged over time, yet the modified Outerbridge classification—originally an arthroscopic tool adapted to MRI—continues to dominate in clinical practice. This review discusses the reasons behind Outerbridge’s ongoing relevance, including its simplicity, practicality, and widespread familiarity. Practical considerations for MRI-based cartilage evaluation are also addressed.