The SFA system for assessing articular cartilage lesions at arthroscopy of the knee

Dougados, Maxime; Ayral, X.; Listrat, V.; Guéguen, A.; Bahuaud, J; Beaufils, Philippe; Béguin, J; Bonvarlet, J. P.; Boyer, T.; Coudane, H.; Delaunay, C.; Dorfmann, H; Dubos, J. P.; Frank, André Günder; Kempf, Jean; Locker, B.; Prudhon, Jean Louis; Thiery, J.

doi:10.1016/s0749-8063(05)80295-6

Cited by 147 publications

(85 citation statements)

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“…The pattern of meniscal injury and the appearance of the anterior cruciate ligaments and articular cartilage were recorded. The French Arthroscopic Society system [22][23][24] was used for assessing lesions of the articular cartilage. Five grades were recorded; grade 0 (normal), grade I (swelling and softening), grade II (superficial fibrillation), grade III (deep fibrillation), and grade IV (exposure of subchondral bone).…”

Section: Methodsmentioning

confidence: 99%

Arthroscopic medial meniscectomy on stable knees

Hulet

Locker

Schiltz

et al. 2001

The Journal of Bone and Joint Surgery. British volume

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W e reviewed 74 partial medial meniscectomies in 57 patients with stable knees, to assess the long-term functional and radiological outcome. The International Knee Documentation Committee score and the residual laxity were assessed in both knees. At the time of surgery the mean age of the patients was 36 ± 11 years and the mean follow-up was 12 ± 1 years. All had a limited medial meniscectomy. The anterior cruciate ligament was intact in all cases. The meniscal tear was vertical in 95% and complex in 5%. The posterior part of the meniscus was removed in 99%. A peripheral rim was preserved in all cases. After 12 years 95% of the patients were satisfied or very satisfied with their knee(s). Objectively, 57% had grade A function and 43% were grade B. The outcome correlated only with the presence of anterior knee pain at final follow-up. In the 49 cases of arthroscopic meniscectomy for which there was a contralateral normal knee there was narrowing of the 'joint-space' in 16% of the operated knees. There was no correlation between this and other parameters such as age or different meniscal pathologies. 18-20We describe a retrospective review of arthroscopic limited medial meniscectomy carried out on stable knees in order to assess the long-term functional and radiological outcome over a 12-year period. Patients and MethodsBetween 1982 and 1986, 305 limited medial meniscectomies in patients with an intact anterior cruciate ligament were undertaken in our institution. No other procedure was performed. All these patients were sent up to four letters of invitation to return for review. Telephone contact was also attempted. Only one-third replied. Their place of residence, distance to travel and the cost were some of the reasons why so few returned for re-examination. We therefore reviewed 74 knees in 57 patients (17 bilateral) at a minimum follow-up of at least ten years. Most of the patients were men (81%) and the right knee was involved in 59%. The mean age at operation was 36 ± 11 years with 34% being more than 40 years of age. At review, the mean age was 48 ± 10 years and the mean follow-up 12 ± 1 years.Of these 57 patients, 31% undertook strenuous activities (class I) before surgery, 23% moderate (class II) and 46% only light activities (class III). There was a history of playing sport in 57% of the patients, mainly soccer (34%). Pivot and contact sports were undertaken in 43%. There was a history of trauma in 52%.The patients were reviewed clinically and radiologically by an independent examiner. The follow-up clinical examination was based on the International Knee Documentation Committee (IKDC) score. Residual laxity in both knees was assessed for with a manual KT-1000 instrument (MEDmetric Corporation, San Diego, California). We graded patients A, B, C or D according to the IKDC score. Return to sports was evaluated at the five-year follow-up, but not at the final review.

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Section: Methodsmentioning

confidence: 99%

Arthroscopic medial meniscectomy on stable knees

Hulet

Locker

Schiltz

et al. 2001

The Journal of Bone and Joint Surgery. British volume

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“…less affected cartilage (LA-cartilage; Grade 0-1) and severely affected cartilage (SA-cartilage; Grade 2-3). The grading was performed based on the methods proposed by Dougados et al (1994). This assessment is either a continuous variable (scoring) or a semiquantitative variable (grading) related to the three key features of cartilage damage: localization, depth, and surface.…”

Section: Discussionmentioning

confidence: 99%

Comparative Study on Cartilage Tissue Collected From Less- and Severely-Affected Region of Osteoarthritic Knee

Roy¹

2018

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“…21 New classification systems focus mainly on objective parameters, such as lesion depth and extent, and less on surface/superficial properties. 14,17,22,23 Although the modified Outerbridge classification 15 is widely accepted for arthroscopic grading of cartilage lesions, in the cadaver study of Cameron et al, 24 it demonstrated only moderate validity, depending on the localization and severity of the lesions. 15,25 Precise data on a lesion's characteristics, such as location, depth and surface area, as well as the status of the contiguous cartilage, are essential for both diagnosis and optimal treatment choice.…”

Section: Discussionmentioning

confidence: 99%

Mapping tibiofemoral gonarthrosis: an MRI analysis of non-traumatic knee cartilage defects

Evangelopoulos

Huesler

Ahmad

et al. 2015

BJR

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Objective: Arthroscopy is "the gold standard" for the diagnosis of knee cartilage lesions. However, it is invasive and expensive, and displays all the potential complications of an open surgical procedure. Ultra-high-field MRI now offers good opportunities for the indirect assessment of the integrity and structural changes of joint cartilage of the knee. The goal of the present study is to determine the site of early cartilaginous lesions in adults with non-traumatic knee pain. Methods: 3-T MRI examinations of 200 asymptomatic knees with standard and three-dimensional doubleecho steady-state (3D-DESS) cartilage-specific sequences were prospectively studied for early degenerative lesions of the tibiofemoral joint. Lesions were classified and mapped using the modified Outerbridge and modified International Cartilage Repair Society classifications.Results: A total of 1437 lesions were detected: 56.1% grade I, 33.5% grade II, 7.2% grade III and 3.3% grade IV. Cartographically, grade I lesions were most common in the anteromedial tibial areas; grade II lesions in the anteromedial L5 femoral areas; and grade III in the centromedial M2 femoral areas. Conclusion: 3-T MRI with standard and 3D-DESS cartilagespecific sequences demonstrated that areas predisposed to early osteoarthritis are the central, lateral and ventromedial tibial plateau, as well as the central and medial femoral condyle. Advances in knowledge: In contrast with previous studies reporting early cartilaginous lesions in the medial tibial compartment and/or in the medial femoral condyle, this study demonstrates that, regardless of grade, lesions preferentially occur at the L5 and M4 tibial and L5 and L2 femoral areas of the knee joint.

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The SFA system for assessing articular cartilage lesions at arthroscopy of the knee

Cited by 147 publications

References 3 publications

Arthroscopic medial meniscectomy on stable knees

Arthroscopic medial meniscectomy on stable knees

Comparative Study on Cartilage Tissue Collected From Less- and Severely-Affected Region of Osteoarthritic Knee

Mapping tibiofemoral gonarthrosis: an MRI analysis of non-traumatic knee cartilage defects

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