Effect of meniscal damage on the development of frequent knee pain, aching, or stiffness

Abstract

Objective. To evaluate the effect of meniscal damage on the development of frequent knee pain, aching, or stiffness in middle-aged and older adults.Methods. The Multicenter Osteoarthritis Study is a prospective study of 3,026 individuals 50 years of age or older who have or are at high risk of developing knee osteoarthritis (OA). We investigated knees at baseline and at 15 months. Case knees (n ‫؍‬ 110) were those with no pain, aching, or stiffness on most days at baseline, but that had developed frequent pain, aching, or stiffness at 15 months. Control knees (n ‫؍‬ 220) were drawn randomly from knees with no frequent symptoms at baseline that did not become case knees. Using 1.0T magnetic resonance imaging performed at baseline and at followup, 2 musculoskeletal radiologists blinded to the case-control status assessed the meniscal damage using the following scale: 0 ‫؍‬ intact, 1 ‫؍‬ minor tear, 2 ‫؍‬ nondisplaced tear or prior surgical repair, and 3 ‫؍‬ displaced tear, resection, maceration, or destruction. The effect of meniscal damage was analyzed by contingency tables and logistic regression.Results. Meniscal damage was common at baseline both in case knees (38%) and in control knees (29%). Although there was a modest association between the meniscal damage score (range 0-3) and the development of frequent knee pain, aching, or stiffness (odds ratio [OR] 1.21, 95% confidence interval [95% CI] 0.96-1.51, adjusted for age, sex, and body mass index), meniscal damage was mostly present in knees with OA. When considering the co-occurrence of OA, we found no independent association between meniscal damage and the development of frequent knee symptoms (OR 1.05, 95% CI 0.80-1.37).Conclusion. In middle-aged and older adults, any association between meniscal damage and the development of frequent knee pain seems to be present because both pain and meniscal damage are related to OA and not because of a direct link between the two.

Arthroscopic Partial Meniscectomy versus Sham Surgery for a Degenerative Meniscal Tear

“…2,[31][32][33] For example, one study showed no significant association between the presence of meniscal damage and the development of frequent knee pain in middle-aged and older adults, once the co-occurrence of osteoarthritis at baseline was taken into account. 34 Previous cohort studies have suggested that progression of osteoarthritis may be more rapid in persons who have undergone arthroscopic partial meniscectomy 35,36 ; it is uncertain whether this is an effect of the surgery. 37 Longterm follow-up of patients in the present trial and in other trials 8,38 is needed to address this question.…”

Diagnostic accuracy of the Thessaly test, standardised clinical history and other clinical examination tests (Apley’s, McMurray’s and joint line tenderness) for meniscal tears in comparison with magnetic resonance imaging diagnosis

“…Tears in this age group usually result from long-term degeneration of the meniscus itself and cause joint swelling, joint line pain and mechanical locking. [8][9][10] The presence of meniscal tears has been identified as an important risk factor in the development of knee osteoarthritis. 10,11 Degenerative meniscal tears are associated with articular cartilage defects, loss of articular cartilage volume and prevalence of radiographical osteoarthritis.…”

Implementation of Discrete Element Analysis for Subject-Specific, Population-Wide Investigations of Habitual Contact Stress Exposure

“…The feasibility of the DEA implementation was established using data from the NIH/NIAfunded Multicenter Osteoarthritis (MOST) study (Englund et al, 2007). The MOST study used a population-based sampling frame to recruit 3026 community-dwelling men and women, age 50-79 years, with frequent knee symptoms (progression cohort) or at risk for developing symptomatic knee OA, based on a history of knee injury, surgery, or being overweight/obese (incidence cohort).…”

“…For the most part, however, these studies have involved lengthy and concerted efforts in well-controlled research settings, and have yielded articular contact stresses for only small numbers of cases. The high logistical cost of performing 3-D contact FEA on a subject-or patient-specific basis makes FEA of limited attraction for stress analysis in large epidemiologic studies (Englund et al, 2007;Felson & Nevitt, 2004;Lester, 2008). Advancement of expeditious methods for determining in vivo articular contact stress distributions will enhance the understanding of normal articular function, and of the mechano-pathology of OA.…”