Cartilaginous debris in the injured human knee. Correlation with arthroscopic findings

Cytologic analysis of filtered synovial lavage was compared with the independent arthroscopic findings in 70 patients with knee pain secondary to injury. Correlation existed between the arthroscopic evaluation of the articular surfaces and the presence of cartilaginous fragments and their microscopic features. Study of the filtered lavage was carried out without knowledge of the patient's clinical status or arthroscopic findings. Patients with unblemished articular surfaces and normal menisci demonstrated essentially no fragments in the synovial lavage. Minimal fibrillation of the articular surface with normal menisci was associated with few cartilage fragments per sample. Patients with moderate to severe fibrillation of the articular surface requiring a surface altering procedure, demonstrated significantly more fragments per sample. Chondrocyte nuclei were visible in these fragments, often arranged in multicellular clusters. Isolated lesions of the meniscus were associated with cartilage fragments that did not contain chondrocyte nuclei. Microscopic analysis of synovial lavage may serve as a useful diagnostic adjunct in the evaluation of the painful knee and the study of the pathogenic role of cartilage fragments is osteoarthrosis.