Histological/Histochemical Grading System (HHGS) of Mankin et al for Articular Cartilage in a Patient with Osteoarthritis

Mankin et al developed a score for evaluating cartilage from an osteoarthritic joint.

Patient selection: osteoarthritis

Parameters:

(1) structure

(2) cellularity

(3) safranin O staining

(4) tidemark integrity

Parameter	Finding	Points
structure	normal	0
	surface irregularities	1
	pannus and surface irregularities	2
	clefts to transitional zone	3
	clefts to radial zone	4
	clefts to calcified zone	5
	complete disorganization	6
cellularity	normal	0
	diffuse hypercellularity	1
	cloning	2
	hypocellularity	3
safranin O staining	normal	0
	slightly reduced	1
	moderately reduce	2
	severely reduced	3
	no staining	4
tidemark integrity	inact	0
	crossed by blood vessels	1

total score =

= SUM(points for all 4 paramters)

Interpretation:

• minimum score: 0

• maximum score: 14

• The higher the score the more severe the osteoathritis.

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