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. 2021 Mar 3;103(5):381-388.
doi: 10.2106/JBJS.20.01193.

Meniscal and Mechanical Symptoms Are Associated with Cartilage Damage, Not Meniscal Pathology

Evan M Farina  1 , Natalie A Lowenstein  1 , Yuchiao Chang  1   2 , Kaetlyn R Arant  1 , Jeffrey N Katz  1 , Elizabeth G Matzkin  1
Affiliations

Meniscal and Mechanical Symptoms Are Associated with Cartilage Damage, Not Meniscal Pathology

Evan M Farina et al. J Bone Joint Surg Am. .

Abstract

Background: Traditionally defined "meniscal" and "mechanical" symptoms are thought to arise from meniscal tears. Yet meniscal tears and cartilage damage commonly coexist in symptomatic knees. To better characterize the primary driver of these symptoms, we investigated whether the presence of preoperative patient-reported knee symptoms (PRKS), including knee catching/locking, grinding/clicking/popping, and pain with pivoting, are associated with various intra-articular pathological conditions diagnosed at knee arthroscopy.

Methods: We collected prospective data from 565 consecutive patients who underwent knee arthroscopy from 2012 to 2019 and had PRKS collected via the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire. The diagnosis of meniscal pathology and concomitant cartilage damage was confirmed and classified intraoperatively. We used multivariable regression models, adjusting for possible confounders, to examine the association of specific pathological conditions of the knee with the presence of preoperative PRKS.

Results: Tricompartmental cartilage damage was strongly associated with significantly worse PRKS, with an increase of 0.33 point (95% confidence interval [CI] = 0.08 to 0.58; p = 0.01) on a 0 to 4-point scale. We did not observe an association between meniscal pathology and preoperative PRKS.

Conclusions: Contrary to current dogma, this study demonstrates that traditionally defined "meniscal" and "mechanical" knee symptoms are strongly associated with the burden and severity of underlying cartilage damage rather than with specific meniscal pathology.

Level of evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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Conflict of interest statement

Disclosure: The authors indicated that no external funding was received for any aspect of this work. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked “yes” to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work (http://links.lww.com/JBJS/G273).

Comment in

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