title: The pattern of cartilage damage in antero-medial osteoarthritis of the knee and its relationship to the anterior cruciate ligament.
abstract: Within antero-medial gonarthrosis (AMG) of the knee, there is a spectrum of damage seen in the functionally intact anterior cruciate ligament (ACL). Our aim was to correlate the degree of ACL damage to the geographical extent and degree of cartilage loss on the tibial plateau. Ninety tibial plateaus resected during unicompartmental arthroplasty were photographed and digitally mapped. The ACL damage was graded (0: normal, 1: synovium loss, 2: longitudinal splits), and dimensions of full thickness cartilage loss and damage recorded. The percentage of full thickness loss in patients with a normal ACL was compared to those with a damaged, but functionally intact ligament. All specimens showed similar elliptical loss of cartilage in the antero-medial part of the tibial plateau. A total of 45(50%) patients had a macroscopically normal ACL, 21(23%) had synovial loss, and 24(27%) had longitudinal splits. An increase in the area of cartilage damage was seen with progressive ACL damage (p < 0.001). The area of macroscopically normal cartilage found posteriorly did not change. This study demonstrates that phenotypic distribution of cartilage damage in AMG is highly reproducible with a pattern of increasing cartilage erosion associated with increasing ACL damage.
authors: Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, NIHR Biomedical Research Unit, Nuffield Orthopaedic Centre, University of Oxford, Oxford, United Kingdom.
authors: Raj
authors: R
authors: Rout
authors: Stephen
authors: S
authors: McDonnell
authors: Philippa
authors: P
authors: Hulley
authors: Chethan
authors: C
authors: Jayadev
authors: Tanvir
authors: T
authors: Khan
authors: Andrew
authors: A
authors: Carr
authors: David
authors: D
authors: Murray
authors: Harinderjit
authors: H
authors: Gill
authors: Andrew
authors: A
authors: Price
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016118:Anterior Cruciate Ligament / Q000473:pathology*; D002358:Cartilage, Articular / Q000473:pathology*; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000473:pathology*; D013977:Tibia / Q000473:pathology*