Gross pathological changes in the knee joint of the aged individual: a study of 300 cases

The incidence of chondromalacia of the pattella and degenerative arthritis of the knee is based on conjectural rather than objective autopsy observations. The notion that chondromalacia is a disabling, troublesome and almost universal disease affecting most older individuals is chiefly derived from clinical impressions of physicians who treat arthritis plus a few reports of European authors published some 50 years ago. The present investigation of 300 cadaver knees, whose average age was 70 years, demonstrates a much lower incidence of degenerative lesions of the articular cartilage than might be expected. There was minimal or no damage to the patella in 62% of the cases and an even lower incidence of 23% in the weight-bearing areas of the joint. Eighty-two per cent of the menisci were essentially normal, as were 96% of the cruciates. In patients in the U.S.A., articular cartilage of the knee resists the wear and tear of a normal lifespan remarkably well and infrequently undergoes progressive degradation.