Abstract
BackgroundThe aim of this study was to examine the prevalence of self-reported and clinical knee morbidity among floor layers compared to a group of graphic designers, with special attention to meniscal status.MethodsWe obtained information about knee complaints by questionnaire and conducted a bilateral clinical and radiographic knee examination in 134 male floor layers and 120 male graphic designers. After the exclusion of subjects with reports of earlier knee injuries the odds ratio (OR) with 95% confidence intervals (CI) of knee complaints and clinical findings were computed among floor layers compared to graphic designers, using logistic regression. Estimates were adjusted for effects of body mass index, age and knee straining sports. Using radiographic evaluations, we conducted side-specific sensitivity analyses regarding clinical signs of meniscal lesions after the exclusion of participants with tibiofemoral (TF) osteoarthritis (OA).ResultsReports of knee pain (OR = 2.7, 95% CI = 1.5–4.6), pain during stair walking (OR = 2.2, 95% CI = 1.3–3.9) and symptoms of catching of the knee joint (OR = 2.9, 95% CI = 1.4–5.7) were more prevalent among floor layers compared to graphic designers. Additionally, significant more floor layers than graphic designers had clinical signs suggesting possible meniscal lesions: a positive McMurray test (OR = 2.4, 95% CI = 1.1–5.0) and TF joint line tenderness (OR = 5.4, 95% CI = 2.4–12.0). Excluding floor layers (n = 22) and graphic designers (n = 15) with radiographic TF OA did not alter this trend between the two study groups: a positive McMurray test (OR = 2.2, 95% CI = 1.0–4.9), TF joint line tenderness (OR = 5.0, 95% CI = 2.0–12.5).ConclusionResults indicate that floor layers have a high prevalence of both self-reported and clinical knee morbidity. Clinical knee findings suggesting possible meniscal lesions were significant more prevalent among floor layers compared to a group of low-level exposed graphic designers and an association with occupational kneeling could be possible. However, causality cannot be confirmed due to the cross-sectional study design.
Highlights
The aim of this study was to examine the prevalence of self-reported and clinical knee morbidity among floor layers compared to a group of graphic designers, with special attention to meniscal status
In this respect there has been few reports concerning the association between occupational related factors and meniscal lesions. [10,11,12,13] Early studies in the 1950s and 1960s showed an increased prevalence of meniscal damage among miners who had a significant proportion of kneeling work in their work tasks and in a more recent case-control study of hospital treated meniscal injuries, Baker et al showed that degenerative lesions were increased almost 4-fold among workers with occupational kneeling. [11,12,13] Few previous studies have focused on clinical knee morbidity among floor layers.[2,14,15,16]
Clinical signs suggesting possible meniscal lesions e.g. tenderness on palpating the TF joint lines and a positive McMurray test was significantly more prevalent among floor layers compared to graphic designers and evaluation of patellar stability by the patellar tracking test revealed significantly more observations of lateral patellar displacement among floor layers (OR = 8.3, 95% confidence interval (CI) = 1.8–38.9)
Summary
The aim of this study was to examine the prevalence of self-reported and clinical knee morbidity among floor layers compared to a group of graphic designers, with special attention to meniscal status. Floor layers are in particular exposed to repetitive and prolonged periods of kneeling work and only few jobs have the same level of knee demands as workers in this profession. Knee morbidity may be attributable to acute or chronic injuries on these structures and explain earlier reports of prolonged sick leave and premature retirement among floor layers. Several studies have focused on the association between kneeling and knee osteoarthritis (OA) and it has been shown that floor layers have an increased prevalence of knee OA. Knee morbidity may be attributable to other pathologies than OA In this respect there has been few reports concerning the association between occupational related factors and meniscal lesions. In this respect there has been few reports concerning the association between occupational related factors and meniscal lesions. [10,11,12,13] Early studies in the 1950s and 1960s showed an increased prevalence of meniscal damage among miners who had a significant proportion of kneeling work in their work tasks and in a more recent case-control study of hospital treated meniscal injuries, Baker et al showed that degenerative lesions were increased almost 4-fold among workers with occupational kneeling. [11,12,13] Few previous studies have focused on clinical knee morbidity among floor layers.[2,14,15,16] only one of these studies evaluated clinical signs of meniscal lesions and they found an even distribution of tibiofemoral (TF) joint line tenderness between floor layers and a reference group of painters.[14]
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