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Chondral Injury Classification

 ICRS Grading
  • www.cartilage.org
  • Grade 0: normal
  • Grade 1: Nearly Normal (soft indentation and/or superficial fissures and cracks
  • Grade 2: Abnormal (lesions extending down to <50% of cartilage depth
  • Grade 3: Severly Abnormal (carilage defects >50% of cartilage depth
  • Grade 4: Severly abnormal (through the subchondral bone)
Outerbridge System
  • Grade I: Softening and swelling of cartilage
  • Grade II: Fragmentation and fissuring, less than 0.5-in diameter
  • Grade III: Fragmentation and fissuring, greater than 0.5-in diameter
  • Grade IV: Erosion of cartilage down to exposed subchondral bone

 

Noyes System
  • Grade 1: Cartilage surface intact (1A = some remaining resilience; 1B = deformation)
  • Grade 2A: Cartilage surface damaged (cracks, fibrillation, fissuring, or fragmentation); with less than half of cartilage thickness involved
  • Grade 2B: Depth of involvement greater than half of cartilage thickness but without exposed bone
  • Grade 3: Bone exposed (3A = surface intact; 3B = surface cavitation)
Normal Articular Cartilage picture Normal Articular Cartilage
  • ICRS Grade 0: normal
  1. Normal articular cartilage on inferior pole of the patella
  2. Trochear groove of distal femur
ICRS Grade 1 picture
  • ICRS Grade 1: Nearly Normal (soft indentation and/or superficial fissures and cracks
  • Outerbridge Grade I: Softening and swelling of cartilage
  • Noyes Grade 1: Cartilage surface intact (1A = some remaining resilience; 1B = deformation)
  1. Soft indentation and superficial fissures on inferior pole of the patella
  2. Trochear groove of distal femur
ICRS Grade 2 picture
  • ICRS Grade 2: Abnormal (lesions extending down to <50% of cartilage depth
  • Outerbridge Grade II: Fragmentation and fissuring, less than 0.5-in diameter
  • Noyes Grade 2A: Cartilage surface damaged (cracks, fibrillation, fissuring, or fragmentation); with less than half of cartilage thickness involved
  1. Fragmentation and fissuring extending down <50% of the depth of the cartilage on the medial facet and inferior pole of the patella
  2. Trochear groove of distal femur
ICRS Grade 3 picture
  • ICRS Grade 3: Severly Abnormal (carilage defects >50% of cartilage depth
  • Outerbridbe Grade III: Fragmentation and fissuring, greater than 0.5-in diameter
  • Noyes Grade 2B: Depth of involvement greater than half of cartilage thickness but without exposed bone
  1. Fragmentation and fissuring extending down >50% of the depth of the cartilage on the medial facet of the patella
  2. Trochear groove of distal femur
ICRS Grade 4 picture
  • ICRS Grade 4: Severly abnormal (through the subchondral bone)
  • Outerbridge Grade IV: Erosion of cartilage down to exposed subchondral bone
  • Noyes Grade 3: Bone exposed (3A = surface intact; 3B = surface cavitation)
  1. Erosion of cartilage down to exposed subchondral bone on the lateral facet of the patella
  2. Trochear groove of distal femur

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