Abstract
Aim: This study investigated the causes of meniscal tears in an unselected adult population. No epidemiological study of this type has been undertaken since the advent of arthroscopy and MRI.
Method: The notes of all patients (1236 cases) who underwent arthroscopic surgery under the care of one knee surgeon working in a District General Hospital between 1992 and 1998 were scrutinised. 392 patients aged between 18–60 years, with normal X-rays, no previous knee injury, surgery, or arthritis, and arthroscopically proven meniscal tears, form the basis of this study.
Results: Sports injuries (Group 1) occurred in 32.4% patients. Non-sporting injuries (Group 2) accounted for 38.8% patients, 71.9% of which happened in normal daily activities. Half occurred on rising from squatting position. No Injury (Group 3) was identified in 28.8% of patients. Average age of sports group was 33 years, non-sporting group 41 years & no injury group 43 years. Male:Female = 4: 1.
Age v cause: In patients under 20 years of age meniscal tears occurred mainly in sports. In patients 20–29 years, 64.5% were related to sports, 25% to non-sporting activities & 10.5% no specific injury. Between 30–39 years, distribution was about equal in each group. In patients aged 40–49, & 50–59 years sports related tears dropped below 20%, whilst non-sporting and spontaneous tears rose to 45% and 35% respectively.
A detailed analysis of: i) the tears in relation to different sports, ii) the nature of non-sporting injuries, iii) the pathological types and distribution of tears, and iv) the associated intra-articular injuries will be presented.
Conclusions: Approximately two thirds of meniscal tears in the general population occurred during normal daily activities and in the absence of sporting injury. In nonsporting injuries the mechanism of the tears was often unrelated to loading in flexion. Tears occurred in the absence of definitive injuries even in early adulthood and middle years. Degenerative change may contribute to the pathological mechanism of meniscal tears at an earlier age than generally appreciated. Ascent from the squatting position is an important common mechanism of injury not generally described or emphasised.
The abstracts were prepared by Mr R. B. Smith. Correspondence should be addressed to him at the British Orthopaedic Association, Royal College of Surgeons, 35-43 Lincoln’s Inn Fields, London WC2A 3PN.
