BOSTON, Massachusetts—Osteoarthritis (OA) causes both persistent knee pain and meniscal damage in middle-aged and older adults, according to new research in the December issue of Arthritis & Rheumatism.¹

"Any association between meniscal damage and 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," concluded study author Martin Englund, MD, PhD, of Boston University School of Medicine in Massachusetts.

Meniscal damage common in knees with and without pain

The new data come from the Multicenter Osteoarthritis Study, a prospective study of 3026 individuals 50 years of age or older who have or are at high risk of developing knee OA. The researchers looked at 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.

The knees underwent magnetic resonance imaging scans at baseline and at follow-up. Two musculoskeletal radiologists rated the meniscal damage as 0 if it was intact, 1 if there was a minor tear, 2 for a nondisplaced tear or prior surgical repair, and 3 for a displaced tear, resection, maceration, or destruction. Then, the effect of meniscal damage on the development of frequent knee pain, aching, or stiffness was analyzed by contingency tables and logistic regression.

Meniscal damage was common at baseline, occurring in 38% of case knees and 29% of control knees. Meniscal damage was more frequent in knees in which previous or serious injury had been reported. There was a modest association between the meniscal damage score and the development of frequent knee pain, aching, or stiffness, but meniscal damage was mostly present in knees with OA at baseline after adjusting for age, sex, and body mass index.

There was no independent association between meniscal damage and the development of frequent knee symptoms when researchers factored in the co-occurrence of OA.

"Meniscal damage in older adults is highly associated with OA of the knee. However, meniscal damage often seems not to be directly responsible for later symptoms, while other features of OA may be so," the researchers concluded.

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