Evaluation of Cartilage Injuries and Repair

Articular cartilage injuries ( Fig. 1 ) are common findings during arthroscopy 1 and diagnostic imaging of the joints 2,3. While there are many techniques for the treatment of cartilage injuries, not enough is known about which lesions need treatment or about the proper treatment modality for a particular lesion. More objective data regarding cartilage injuries and more accurate methods to evaluate the operative outcomes are required, especially since new procedures are becoming increasingly expensive. There are many published reports on the outcomes of total joint replacement based on clinical scores and radiographic evaluations. However, it has been quite difficult to interpret the reported results of the repair of focal cartilage defects as there is no universally accepted system to describe the lesions, the repair tissue, or the clinical symptoms for this category of patients. More studies on clinical articular cartilage resurfacing will appear in the future, making it important to develop common evaluation measurement tools and standards. The International Cartilage Repair Society (ICRS) was founded in 1997 and has been interested in developing a standardization system for the evaluation of cartilage injury and repair 4,5. A working group of the ICRS was established with the aim of developing a common, easy system for clinical and arthroscopic evaluation ( Table I ). Shortly thereafter, the Articular Cartilage Imaging Committee of the ICRS was created to assess the existing clinical imaging techniques, to recommend specific magnetic resonance imaging techniques for the assessment of articular cartilage 6, and to develop a standardized magnetic resonance imaging evaluation system for native and repaired cartilage ( Table I ). A state-of-the-art system for clinical cartilage evaluation and imaging assessment is presented below. Fig. 1: A cartilage lesion on a femoral condyle, extending deep down to bone. Note that some calcified …