PURPOSE: Arthroscopic evaluation of the articular surface by visualization and palpation has proved to be unreliable; therefore, we investigated arthroscopically procured biopsy specimens and conventional sections by using the same histopathomorphologic techniques and compared the results for possible differences. METHODS: Cartilage biopsy specimens of 1.7 mm in diameter and conventional cartilage sections (pieces of 8 x 2 mm) were removed from the lateral femoral condyle of 53 osteoarthritis patients undergoing total knee arthroplasty. Biopsies and conventional sections were evaluated histologically by using Mankin's grading system and immunohistochemically by assessing the immunoreactivity of the chondrocytes to MMP-1 and MMP-3. RESULTS: The comparison between the biopsies and conventional sections revealed that there were no differences between these forms of obtaining specimens. Moreover, the expression of MMP-1 and MMP-3 in biopsy specimens showed a strong correlation with that in conventional sections. CONCLUSIONS: We conclude that in small biopsy specimens taken (e.g., during arthoscopy), the histological grading of osteoarthritis severity and the evaluation of MMP expression yield results similar to those obtained in conventional sections.