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Meniscal tears common in older adults, even without symptoms

May 12, 2009


The prevalence of meniscal tears in adults increases with age, but often they are not accompanied by knee pain or other symptoms, according to a recent study supported in part by the NIA. Researchers led by Dr. Martin Englund of the Boston University School of Medicine sought to determine the prevalence of damage to menisci, the tissue-filled disks between knee bones. A random sample of 991 adults ages 50–90 in Framingham, MA, filled out questionnaires about symptoms and underwent magnetic resonance imaging (MRI) of their right knees.

The presence of meniscal damage detected by MRI averaged 35 percent overall and rose with age—from 19 percent in women and 32 percent in men between the ages of 50 and 59 to 51 percent in women and 56 percent in men between the ages of 70 and 90. Most participants with meniscal tears (61 percent) reported no pain, aching, or stiffness during the month before the study. In people with knee osteoarthritis, the prevalence of a meniscal tear was 63 percent among those with knee pain, aching, or stiffness on most days and 60 percent among those without these symptoms.

These epidemiologic findings emphasize the difficulties in appropriately interpreting MRI findings of the knee and the relationship of meniscal damage to knee pain. As the researchers note, the study suggests that incidental meniscal findings detected on MRI are likely to be frequent in clinical practice. Clinicians who order MRI of the knee should take into account the high prevalence of incidental tears when interpreting the results and planning therapy.

Reference:

Englund, M., et al. Incidental meniscal findings on knee MRI in middle-aged and elderly persons. N Engl J Med. 2008 Sept 11. 359:1108-15.

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