For the histopathological classification of the severity of osteoarthritic lesions of cartilage, the Mankin score is frequently used. A necessary constraint on the validity of this scoring system is the consistency with which cartilage lesions are classified. The intra- and interobserver agreement of the Mankin score was determined. The intra- and interobserver agreement of the 14-point Mankin score was adequate. Between observers 95% of differences were less than approximately 7 points. By a more strict definition of the elements of the Mankin score, the intraobserver differences were reduced only for some observers. The interobserver differences were only slightly reduced: between observers 95% of differences were less than approximately 6 points. We found the Mankin score to be an adequate histopathological tool.

Twenty-five patients with 30 chondral lesions of the knee were treated with an autogenous strip of costal perichondrium. The graft was fixed to the subchondral bone with Tissucol (Immuno, Vienna), a human fibrin glue. The leg was then immobilised for two weeks followed by two weeks of continuous passive motion.

To evaluate the effect of physiotherapy after partial arthroscopic meniscectomy, we performed a prospective, randomised and partially blinded study. This pilot study was performed from October 1996 to June 1997. The control group received the standard treatment, consisting of verbal and written advice and exercises. The physiotherapy group performed exercises according to a dynamic protocol under the supervision of a physiotherapist. During a 3-week period, nine treatment sessions were given of 30 min each. Twenty patients, who had undergone arthroscopic meniscectomy without any other pathology of the knee, were randomised into two groups of ten patients each. The effects of therapy were evaluated by a blinded observer. We measured the distance and height of one-leg jumps (hops), the VAS pain scale, the Tegner and Lysholm scores and the SARS/FORS score. Recovery and satisfaction with the treatment were also evaluated. The effect measurements were performed at 7 (T1), 14 (T2), 21 (T3) and 28 days (T4) following surgery. Statistical analysis was performed with the Student's t-test. The physiotherapy group showed significantly better results than the control group regarding the SARS score, the hop test and the distance jumps. Moreover, the measurements showed clear progression in favour of the physiotherapy group. In conclusion, exercising under the supervision of a physiotherapist led to high patient satisfaction and good functional rehabilitation after partial arthroscopic meniscectomy.

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