(Fig 5-A.16) Transverse Chondral Flap Lesions in Midzone

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📌 Transverse Chondral Flap Lesions in Midzone
Chondral fissures can lead to cartilage delamination and chondral flap lesions when they extend parallel to the bone surface.
While often occurring at the tidemark, these lesions can also form in the articular cartilage's mid-zone.
✅ Transverse Orientation Midzone Delamination
A transversely oriented region of failure is sometimes observed in the midzone of articular cartilage on MRI.
This phenomenon is often associated with chondral fissures.
Collagen Fiber Disorganization: The transverse failure may represent delamination between pathologically disorganized collagen fibers.
Cellular Architecture: Another explanation relates to the transverse nature of cellular components in articular cartilage, which appear in rows.
✅ Case Study
Chondral delamination typically appears as a thin line of near-fluid signal intensity.
In midzone lesions, this line is seen in the mid to deep zone of the cartilage, superficial to the tidemark.
Some cartilage tissue may remain deep to the surface defect and the flap.
References:
J Knee Surg. 2020 November; 33(11): 1088-1099
MRI Web Clinic - June 2021 Tissue Delamination
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