Grade IV arthritis

Written by Dr Sheila Strover on March 14, 2025

Grade IV arthritis is arthritic destruction of the joint cartilage to the point of exposure of the underlying bone.

Outerbridge Grade 0 cartilage - normal patellar cartilage

Normal joint cartilage

Outerbridge Grade IV - patellar cartilage fibrillated with exposure of underlying bone in the tibia

Grade IV damage

Grading versus pain

Although it looks as if it should always be painful, and it generally is, there are nonetheless many patients with Grade IV cartilage damage who do not experience pain.