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BMC Musculoskeletal Disorders
Published in: BMC Musculoskeletal Disorders 1/2017

Open Access 01-12-2017 | Research article

Risk factors for first hospitalization due to meniscal lesions - a population-based cohort study with 30 years of follow-up

Authors: Tea Kontio, Markku Heliövaara, Harri Rissanen, Paul Knekt, Arpo Aromaa, Svetlana Solovieva

Published in: BMC Musculoskeletal Disorders | Issue 1/2017

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Abstract

Background

Meniscal lesions are among the most common injuries of the knee, yet limited epidemiologic data is available on their risk factors. We investigated the association of lifestyle factors and physical strenuousness of work on knee injuries with a focus on meniscal lesions.

Methods

We examined a nationally representative sample of persons aged 30 to 59 years, who participated in a comprehensive health examination (the Mini-Finland Health Survey). Subjects without any injury or osteoarthritis in the knee joint at baseline (n = 4713) were subsequently followed via the National Hospital Discharge Register up to 30 years.

Results

During the follow-up, 338 knee injuries were identified of which 224 were meniscal lesions. Obesity and regular leisure time physical exercise were associated with an increased risk of first hospitalization due to meniscal lesions (hazard ratio (HR) 1.62 and 95% confidence interval (CI) 1.06–2.48 and 1.53, 95% CI 1.05–2.23, respectively). The types of sports predicting the highest risk of meniscal lesions were ballgames, gymnastics and jogging. Physical strenuousness of work did not predict meniscal lesion. The hazard of other knee injury was increased among those reporting irregular or regular physical exercise at baseline (HR 1.64, 95% CI 1.03–2.64 and 1.88 CI 1.05–2.36, respectively). Smoking or alcohol intake were not associated with knee injuries.

Conclusions

Better safety measures in high-risk sports and weight control would likely improve the prevention of meniscal lesions in populations.
Literature
1.
Hede A, Jensen DB, Blyme P, Sonne-Holm S. Epidemiology of meniscal lesions in the knee. 1,215 open operations in Copenhagen 1982-84. Acta Orthop Scand. 1990;61(5):435–7.CrossRefPubMed
2.
Reid CR, Bush PM, Cummings NH, McMullin DL, Durrani SK. A review of occupational knee disorders. J Occup Rehabil. 2010;20(4):489–501.CrossRefPubMed
3.
Englund M, Guermazi A, Gale D, Hunter DJ, Aliabadi P, Clancy M, Felson DT. Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med. 2008;359(11):1108–15.CrossRefPubMedPubMedCentral
4.
Berthiaume MJ, Raynauld JP, Martel-Pelletier J, Labonte F, Beaudoin G, Bloch DA, Choquette D, Haraoui B, Altman RD, Hochberg M, et al. Meniscal tear and extrusion are strongly associated with progression of symptomatic knee osteoarthritis as assessed by quantitative magnetic resonance imaging. Ann Rheum Dis. 2005;64(4):556–63.CrossRefPubMed
5.
Nielsen AB, Yde J. Epidemiology of acute knee injuries: a prospective hospital investigation. J Trauma. 1991;31(12):1644–8.CrossRefPubMed
6.
Snoeker BA, Bakker EW, Kegel CA, Lucas C. Risk factors for meniscal tears: a systematic review including meta-analysis. The Journal of Orthopaedic and Sports Physical Therapy. 2013;43(6):352–67.CrossRefPubMed
7.
Thorlund JB, Hare KB, Lohmander LS. Large increase in arthroscopic meniscus surgery in the middle-aged and older population in Denmark from 2000 to 2011. Acta Orthop. 2014;85(3):287–92.CrossRefPubMedPubMedCentral
8.
Kim S, Bosque J, Meehan JP, Jamali A, Marder R. Increase in outpatient knee arthroscopy in the United States: a comparison of National Surveys of ambulatory surgery, 1996 and 2006. J Bone Joint Surg Am. 2011;93(11):994–1000.CrossRefPubMed
9.
Bergkvist D, Dahlberg LE, Neuman P, Englund M. Knee arthroscopies: who gets them, what does the radiologist report, and what does the surgeon find? An evaluation from southern Sweden. Acta Orthop. 2016;87(1):12–6.CrossRefPubMed
10.
Bhattacharyya T, Gale D, Dewire P, Totterman S, Gale ME, McLaughlin S, Einhorn TA, Felson DT. The clinical importance of meniscal tears demonstrated by magnetic resonance imaging in osteoarthritis of the knee. J Bone Joint Surg Am. 2003;85-A(1):4–9.CrossRefPubMed
11.
Toivanen AT, Heliövaara M, Impivaara O, Arokoski JP, Knekt P, Lauren H, Kroger H. Obesity, physically demanding work and traumatic knee injury are major risk factors for knee osteoarthritis--a population-based study with a follow-up of 22 years. Rheumatology (Oxford, England). 2010;49(2):308–14.CrossRef
12.
Englund M: The role of the meniscus in osteoarthritis genesis. The Medical Clinics of North America 2009, 93(1):43, x.
13.
Englund M, Guermazi A, Roemer FW, Aliabadi P, Yang M, Lewis CE, Torner J, Nevitt MC, Sack B, Felson DT. Meniscal tear in knees without surgery and the development of radiographic osteoarthritis among middle-aged and elderly persons: the multicenter osteoarthritis study. Arthritis Rheum. 2009;60(3):831–9.CrossRefPubMedPubMedCentral
14.
Khan M, Evaniew N, Bedi A, Ayeni OR, Bhandari M. Arthroscopic surgery for degenerative tears of the meniscus: a systematic review and meta-analysis. CMAJ. 2014;186(14):1057–64.CrossRefPubMedPubMedCentral
15.
Thorlund JB, Juhl CB, Roos EM, Lohmander LS. Arthroscopic surgery for degenerative knee: systematic review and meta-analysis of benefits and harms. BMJ. 2015;350:h2747.CrossRefPubMedPubMedCentral
16.
Thorlund JB, Englund M, Christensen R, Nissen N, Pihl K, Jorgensen U, Schjerning J, Lohmander LS. Patient reported outcomes in patients undergoing arthroscopic partial meniscectomy for traumatic or degenerative meniscal tears: comparative prospective cohort study. BMJ. 2017;356:j356.CrossRefPubMedPubMedCentral
17.
Lohmander LS, Englund PM, Dahl LL, Roos EM. The long-term consequence of anterior cruciate ligament and meniscus injuries: osteoarthritis. Am J Sports Med. 2007;35(10):1756–69.CrossRefPubMed
18.
Kuikka PI, Pihlajamaki HK, Mattila VM. Knee injuries related to sports in young adult males during military service - Incidence and risk factors. Scandinavian Journal of Medicine & Science in Sports. 2011;
19.
Jones JC, Burks R, Owens BD, Sturdivant RX, Svoboda SJ, Cameron KL. Incidence and risk factors associated with meniscal injuries among active-duty US military service members. J Athl Train. 2012;47(1):67–73.CrossRefPubMedPubMedCentral
20.
Baker BE, Peckham AC, Pupparo F, Sanborn JC. Review of meniscal injury and associated sports. Am J Sports Med. 1985;13(1):1–4.CrossRefPubMed
21.
Baker P, Coggon D, Reading I, Barrett D, McLaren M, Cooper C. Sports injury, occupational physical activity, joint laxity, and meniscal damage. J Rheumatol. 2002;29(3):557–63.PubMed
22.
Baker P, Reading I, Cooper C, Coggon D. Knee disorders in the general population and their relation to occupation. Occup Environ Med. 2003;60(10):794–7.CrossRefPubMedPubMedCentral
23.
Ford GM, Hegmann KT, White GL Jr, Holmes EB. Associations of body mass index with meniscal tears. Am J Prev Med. 2005;28(4):364–8.CrossRefPubMed
24.
Lauder TD, Baker SP, Smith GS, Lincoln AE. Sports and physical training injury hospitalizations in the army. Am J Prev Med. 2000;18(3 Suppl):118–28.CrossRefPubMed
25.
Englund M, Felson DT, Guermazi A, Roemer FW, Wang K, Crema MD, Lynch JA, Sharma L, Segal NA, Lewis CE, et al. Risk factors for medial meniscal pathology on knee MRI in older US adults: a multicentre prospective cohort study. Ann Rheum Dis. 2011;70(10):1733–9.CrossRefPubMedPubMedCentral
26.
Kaeding CC, Pedroza AD, Parker RD, Spindler KP, McCarty EC, Andrish JT. Intra-articular findings in the reconstructed multiligament-injured knee. Arthroscopy : The Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 2005;21(4):424–30.CrossRef
27.
Naranje S, Mittal R, Nag H, Sharma R. Arthroscopic and magnetic resonance imaging evaluation of meniscus lesions in the chronic anterior cruciate ligament-deficient knee. Arthroscopy : The Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association. 2008;24(9):1045–51.CrossRef
28.
Swenson DM, Collins CL, Best TM, Flanigan DC, Fields SK, Comstock RD. Epidemiology of knee injuries among U.S. high school athletes, 2005/2006-2010/2011. Med Sci Sports Exerc. 2013;45(3):462–9.CrossRefPubMedPubMedCentral
29.
Poehling GG, Ruch DS, Chabon SJ. The landscape of meniscal injuries. Clin Sports Med. 1990;9(3):539–49.PubMed
30.
Rytter S, Jensen LK, Bonde JP, Jurik AG, Egund N. Occupational kneeling and meniscal tears: a magnetic resonance imaging study in floor layers. J Rheumatol. 2009;36(7):1512–9.CrossRefPubMed
31.
Lehtonen R, Kuusela V: Part 5, Statistical efficiency of the Mini-Finland Health Survey's sampling design. In: The execution of the Mini-Finland Health Survey. Volume ML:65, edn. Helsinki and Turku: Kela (The Finnish Social Insurance Institution); 1986.
32.
Mälkiä E, Impivaara O, Heliövaara M, Maatela J. The physical activity of health and chronically ill adults in Finland at work, at leisure and during commuting. Scand J Med Sci Sports. 1994;4(1):82–7.CrossRef
33.
Mäkela M, Heliövaara M, Sievers K, Knekt P, Maatela J, Aromaa A. Musculoskeletal disorders as determinants of disability in Finns aged 30 years or more. J Clin Epidemiol. 1993;46(6):549–59.CrossRefPubMed
34.
Yeh PC, Starkey C, Lombardo S, Vitti G, Kharrazi FD. Epidemiology of isolated meniscal injury and its effect on performance in athletes from the National Basketball Association. Am J Sports Med. 2012;40(3):589–94.CrossRefPubMed
35.
Gage BE, McIlvain NM, Collins CL, Fields SK, Comstock RD. Epidemiology of 6.6 million knee injuries presenting to United States emergency departments from 1999 through 2008. Acad Emerg Med Off J Soc Acad Emerg Med. 2012;19(4):378–85.CrossRef
36.
Parkkari J, Pasanen K, Mattila VM, Kannus P, Rimpelä A. The risk for a cruciate ligament injury of the knee in adolescents and young adults: a population-based cohort study of 46 500 people with a 9 year follow-up. Br J Sports Med. 2008;42(6):422–6.CrossRefPubMed
37.
Chen E, Maffulli N, Chan KM. Knee injuries produced by recreational sports follow a different pattern than casual injuries. Bulletin (Hospital for Joint Diseases (New York, NY)). 1998;57(2):74–9.
38.
Poulsen MR, Johnson DL. Meniscal injuries in the young, athletically active patient. The Physician and Sports Medicine. 2011;39(1):123–30.CrossRef
39.
Paletta GA, Warren RF. Knee injuries and Alpine skiing. Treatment and rehabilitation. Sports Medicine (Auckland, NZ). 1994;17(6):411–23.CrossRef
40.
Teichtahl AJ, Wluka AE, Wang Y, Strauss BJ, Proietto J, Dixon JB, Jones G, Forbes A, Kouloyan-Ilic S, Martel-Pelletier J, et al. The longitudinal relationship between changes in body weight and changes in medial tibial cartilage, and pain among community-based adults with and without meniscal tears. Ann Rheum Dis. 2014;73(9):1652–8.CrossRefPubMed
41.
42.
Goulston LM, Kiran A, Javaid MK, Soni A, White KM, Hart DJ, Spector TD, Arden NK. Does obesity predict knee pain over fourteen years in women, independently of radiographic changes? Arthritis Care Res (Hoboken). 2011;63(10):1398–406.CrossRef
43.
McGoey BV, Deitel M, Saplys RJ, Kliman ME. Effect of weight loss on musculoskeletal pain in the morbidly obese. J Bone Joint Surg Br. 1990;72(2):322–3.PubMed
44.
Englund M, Roos EM, Roos HP, Lohmander LS. Patient-relevant outcomes fourteen years after meniscectomy: influence of type of meniscal tear and size of resection. Rheumatology (Oxford, England). 2001;40(6):631–9.CrossRef
45.
Noble J. Lesions of the menisci. Autopsy incidence in adults less than fifty-five years old. The Journal of Bone and Joint surgery American. 1977;59(4):480–3.CrossRef
46.
Noble J, Hamblen DL. The pathology of the degenerate meniscus lesion. The Journal of Bone and Joint surgery British Volume. 1975;57(2):180–6.PubMed
47.
Ding C, Martel-Pelletier J, Pelletier JP, Abram F, Raynauld JP, Cicuttini F, Jones G. Meniscal tear as an osteoarthritis risk factor in a largely non-osteoarthritic cohort: a cross-sectional study. J Rheumatol. 2007;34(4):776–84.PubMed
48.
Luthje P, Nurmi I, Kataja M, Heliövaara M, Santavirta S. Incidence of pelvic fractures in Finland in 1988. Acta Orthop Scand. 1995;66(3):245–8.CrossRefPubMed
49.
Sund R, Nurmi-Luthje I, Luthje P, Tanninen S, Narinen A, Keskimäki I. Comparing properties of audit data and routinely collected register data in case of performance assessment of hip fracture treatment in Finland. Methods Inf Med. 2007;46(5):558–66.PubMed
50.
Yang X, Telama R, Leskinen E, Mansikkaniemi K, Viikari J, Raitakari OT. Testing a model of physical activity and obesity tracking from youth to adulthood: the cardiovascular risk in young Finns study. International Journal of Obesity (2005). 2007;31(3):521–7.CrossRef
51.
Borodulin K, Makinen TE, Leino-Arjas P, Tammelin TH, Heliövaara M, Martelin T, Kestila L, Prattala R. Leisure time physical activity in a 22-year follow-up among Finnish adults. Int J Behav Nutr Phys Act. 2012;9:121.CrossRefPubMedPubMedCentral
52.
Pihl K, Englund M, Lohmander LS, Jorgensen U, Nissen N, Schjerning J, Thorlund JB. Signs of knee osteoarthritis common in 620 patients undergoing arthroscopic surgery for meniscal tear. Acta Orthop. 2017;88(1):90–5.CrossRefPubMed
Metadata
Title
Risk factors for first hospitalization due to meniscal lesions - a population-based cohort study with 30 years of follow-up
Authors
Tea Kontio
Markku Heliövaara
Harri Rissanen
Paul Knekt
Arpo Aromaa
Svetlana Solovieva
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Musculoskeletal Disorders / Issue 1/2017
Electronic ISSN: 1471-2474
DOI
https://doi.org/10.1186/s12891-017-1886-5

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