[Typing, grading and staging of osteoarthritis: histopathological assessment of joint degeneration]

Abstract

Osteoarthritis (degenerative arthropathy) is one of the most common diseases particular in the elderly. Osteoarthritis can principally affect all joints, although the knee, hip and phalangeal joints are most commonly involved in a clinically relevant manner. The grading and classification of changes during cartilage degeneration is complex and only partly informative for clinical management. Overall, the process of joint destruction can always be evaluated for the pathogenesis ("typing"), extent ("staging") and the degree of focal damage ("grading"). However, particularly in the final stages of the disease (e. g. in connection with prosthetic surgery) a description and report should be limited to only the most essential features, because no specific clinical relevance exists for further evaluation. Only the identification of secondary types of degenerative changes, due to as yet unknown rheumatoid diseases, gout or extensive osteonecrosis is of particular interest to clinical colleagues (i.e. typing of the joint lesion).