Normal joint cartilage of femur (below) and patella (above) in the knee joint. Grade 0 on the Outerbridge scale
Grade I - softening of the patellar cartilage, which can be dimpled with a rounded probe.
Grade III damage of the patella on the same grading system. The patellar cartilage has become fibrillated and note that the tibia is showing exposed yellowish bone, which would be a grade IV.
Grading joint cartilage damage (Outerbridge)
By recording the Grade, the surgeon will have a simple record for later comparison in case of deterioration or improvement in the joint cartilage.
- Grade 0 - normal
- Grade I - cartilage with softening and swelling
- Grade II - a partial-thickness defect with fissures on the surface that do not reach subchondral bone or exceed 1.5 cm in diameter
- Grade III - fissuring to the level of subchondral bone in an area with a diameter more than 1.5 cm
- Grade IV - exposed subchondral bone
The Outerbridge Classification Predicts the Need for Patellar Resurfacing in TKA. Rodríguez-Merchán EC and Gómez-Cardero P. Clin Orthop Relat Res. 2010 May; 468(5): 1254–1257.
Imaging of articular cartilage. Paunipagar BK and Rasalkar DD. Indian J Radiol Imaging. 2014 Jul-Sep; 24(3): 237–248.
The etiology of chondromalacia patellae. Outerbridge RE. J Bone Joint Surg Br. 1961 Nov;43-B:752-7.