The Classifications of the Chondral Lesions

The diagnosis and classification of the chondral lesions are very crucial due to the ever-rising reported incidence of the cartilage lesions detected on arthroscopy, the complexity involved in their clinical presentations and treatment, and in the varied prognosis that various treatments offer [1]. An ideal classification system should properly document a lesion, guide for the best treatment options, help in interpreting and comparing the results of various treatments and help in determining the prognosis. The available cartilage classification systems are of two types, the magnetic resonance imaging (MRI) based and the arthroscopy based. MRI has a moderate sensitivity to detect chondral lesions, which may be due to less cartilage thickness (<4 mm) and the curved chondral knee surfaces [2, 3]. Type of injury, location, size of the lesion, MRI sequence, strength, etc. can also influence MRI sensitivity [2]. Arthroscopy is considered as the gold standard, even though there is a risk of missing a deeper hidden injury [3]. Thus, MRI and arthroscopy are complementary with MRI being an important non-invasive tool to evaluate the symptomatic knee and arthroscopy being an optimal confirmatory method [3].