Histopathological examination of joint degeneration:: typing, grading and staging of osteoarthritis

Degenerative arthropathy (osteoarthritis) is one of the most common diseases in modern western societies, in particular in the elderly. The classification and grading of changes during cartilage degeneration represent complex endeavors which are only of limited value in daily pathological practice. In general, the process of joint destruction can always be evaluated for the determining pathogenesis (typing), extent (staging) and degree of the most extensive focal damage (grading). However, for routine use one might best restrict description and reporting to the most essential features. This is in particular true for specimens obtained from endoprosthetic surgery (hips and knees), because there is currently no specific clinical relevance for further evaluation. Only the identification of secondary types of degenerative changes, such as those due to unknown rheumatoid disease, gout or extensive osteonecrosis, is of particular interest to the clinical colleague (i.e. typing of the joint lesion).