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. 2025 May 19;12(2):e70276.
doi: 10.1002/jeo2.70276. eCollection 2025 Apr.

Occupational motions such as kneeling and squatting are associated with the increased development of medial meniscus posterior root tears, regardless of the medial posterior tibial slope angle

Koki Kawada  1 , Yusuke Yokoyama  1 , Masanori Tamura  1 , Yuki Okazaki  1 , Toshifumi Ozaki  1 , Takayuki Furumatsu  1   2
Affiliations

Occupational motions such as kneeling and squatting are associated with the increased development of medial meniscus posterior root tears, regardless of the medial posterior tibial slope angle

Koki Kawada et al. J Exp Orthop. .

Abstract

Purpose: The relationship between occupational motions and the medial posterior tibial slope (MPTS) with the development of medial meniscus posterior root tears (MMPRTs) has not been investigated. The development of non-traumatic degenerative MMPRTs may be influenced by repetitive occupational motions and bone morphological characteristics. Herein, we examined the association between occupational motions and MPTS in patients with MMPRT development.

Methods: During the first medical examination, MPTS was measured using lateral knee radiographic images, and occupational motions were investigated in 559 patients (591 knees). Occupational motions were classified as kneeling and squatting, standing and walking, sitting, lifting heavy weights, and housework. Mann-Whitney U test was used to compare patient characteristics between male and female patients and MPTS relative to occupational motion.

Results: The most frequent occupational motion was housework (160/559 patients, 28.6%), followed by kneeling and squatting (140/559, 25.0%), standing and walking (128/559, 22.9%), sitting (82/559, 14.7%), and lifting heavy weights (49/559, 8.8%). Furthermore, housework (10.0 ± 2.6°) involved significantly greater MPTS than kneeling and squatting (9.3 ± 2.7°; p = 0.012). However, the MPTS associated with other occupational motions was not significantly different from that associated with housework.

Conclusion: The most frequent occupational motion among patients with MMPRTs was housework, followed by kneeling and squatting. Patients who performed housework tended to have a higher MPTS. Occupational motions such as kneeling and squatting potentially increase the development of MMPRTs, even without a high MPTS.

Level of evidence: Level IV.

Keywords: kneeling; meniscus; occupational motion; posterior root tear; posterior tibial slope.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Measurement methods of MPTS. MPTS was defined as the angle between the line perpendicular to the tibial bone axis (white line) and the medial tibial plateau (red line). The longitudinal tibial bone axis (blue dotted line) was defined by the line created by connecting the midpoint of the anteroposterior diameter of the tibia just inferior to the tibial tubercle (Line 1) and the midpoint of the anteroposterior diameter of the tibial shaft 5 cm distal from Line 1 (Line 2). MPTS, medial posterior tibial slope.
Figure 2
Figure 2
Occupational motions in patients with MMPRTs. The figure presents schematic illustrations of each occupational motion and the corresponding percentages in the pie chart. MMPRTs, medial meniscus posterior root tears.
Figure 3
Figure 3
Occupational motions in male and female patients with MMPRTs. The percentage of patients performing each occupational motion is shown in the bar graph. MMPRTs, medial meniscus posterior root tears.
See this image and copyright information in PMC

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