(Fig 5-A.10) Cartilage Damage Terminology

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📌 Cartilage Damage Terminology

1️⃣. Fibrillation 

• Fibrillation results in cartilage surface irregularity, related to the disorganization of the horizontally oriented collagen bundles in the superficial cartilage layers. 
• When excessive shear forces develop near the surface, surface-layer damage of the articular cartilage can occur, including fibrillation or fissuring.

 

2️⃣. Fissure or Fissuring 

• A fissuring is defined as a long and narrow split or crack. 
• Chondral fissuring occurs primarily as a result of delamination between the obliquely and vertically oriented collagen fibrils rather than by breakage of collagen fibrils. 
• Chondral fissures that extend deep can propagate perpendicular to the bone. 
• These lesions can be associated with reactive bone marrow edema that calls attention to the lesion and aids in detection with MRI.

 

3️⃣. Cartilage Delamination 

• Cartilage delamination separates the articular cartilage at the tidemark from the underlying subchondral bone. 
• The tidemark separates more readily than the junction between cartilage and subchondral bone.

 

4️⃣. Chondral Flap Lesion 

• Chondral fissures may result in delamination of the cartilage and chondral flap lesions if there is extension of the fissure parallel to the surface of the bone.

 

5️⃣. Transversely-Oriented Chondral Failure in the Midzone 

• On MRI, a transversely oriented region of failure in the midzone of articular cartilage is sometimes seen in association with chondral fissures.
•  The transversely oriented region of failure that is sometimes seen in the midzone of articular cartilage may represent delamination between pathologically disorganized collagen fibers. 
• Unstable chondral flap delaminating portions of the superficial and transitional zone can also be observed.

 

References

1. MRI Web Clinic – June 2021 Tissue Delamination
2. J Knee Surg. 2020 Nov;33(11):1088-1099
3. AJR 2017; 209:W317–W321
   
   

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#CartilageDamage, #Fibrillation, #Fissuring, #CartilageDelamination, #ChondralFlapLesion, #MRI, #BoneMarrowEdema, #ArticularCartilage, #Orthopedics, #KneeSurgery