Abstract
BackgroundMeniscal lesions are common and are associated with the development of knee osteoarthritis. Knee-straining activities at work such as kneeling or squatting cause high biomechanical stresses on the knee joints that can lead to acute or chronic injuries. The objective of this systematic review is to update the evidence on the potential relationship between occupational risk factors and meniscal lesions.MethodsWe searched the Medline, Embase and Web of Science databases until August 2021 to identify epidemiological observational studies on the association between occupational risk factors and meniscal lesions. Study selection, data extraction and risk of bias assessment were performed independently by two reviewers. Effect measures were extracted from individual studies and pooled with random effects meta-analysis. Heterogeneity analyses were conducted. We used GRADE (Grades of Recommendations, Assessment, Development and Evaluation) to assess the overall quality of evidence.ResultsThe database search resulted in 11,006 references, and 46 additional studies were identified through hand search. Twenty-two studies (represented in 25 publications) met the predefined eligibility criteria and nine records were included in the meta-analysis. There was only one study with an overall low risk of bias. Significant associations between occupational risk factors and the development of meniscal lesions were found for kneeling (effect size (ES) 2.15, 95% CI 1.67–2.76), squatting (ES 2.01, 95% CI 1.34–3.03), climbing stairs (ES 2.28, 95% CI 1.58–3.30), lifting and carrying weights ≥ 10 kg (ES 1.63, 95% CI 1.35–1.96), lifting and carrying weights ≥ 25 kg (ES 1.56, 95% CI 1.08–2.24), playing football on a professional level (ES 5.22, 95% CI 3.24–8.41), working as a hard coal miner (ES 5.23, 95% CI 2.16–12.69) and floor layers (ES 1.99, 95% CI 1.43–2.78). The overall quality of evidence according GRADE was moderate to low.ConclusionWe found consistent evidence of an increased risk of meniscal lesions by occupational knee-straining exposures. Our findings are important for the development of preventive strategies to reduce work-related knee disorders and work absence.Trial registrationPROSPERO (registration no. CRD42020196279).
Highlights
Meniscal lesions are common and are associated with the development of knee osteoarthritis
Full text assessment was performed on 84 studies, including 46 additional articles identified through citation tracking, screening of reference lists and grey literature
Nine studies were eligible for meta-analysis
Summary
Meniscal lesions are common and are associated with the development of knee osteoarthritis. Meniscal lesions are common and knee meniscectomy is the most common procedure performed by orthopedic surgeons [1] They are typically categorized as traumatic or non-traumatic based on their etiology. Structural damages in particular need not to correlate with the presence of pain [6] and often (52.1–78.1%) occur without symptoms [3, 7, 8]. They are challenging to assess, and incidence might be underreported. The overall pooled prevalence of meniscal tears was 10%, with higher prevalence in individuals ≥ 40 years of age (19%). The prevalence of meniscal injuries in asymptomatic athletes was even higher with changes of meniscal tissue in 31% [10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
