Clinical knee findings in floor layers with focus on meniscal status

Department of Orthopaedics, Regional Hospital Viborg, Denmark.
BMC Musculoskeletal Disorders (Impact Factor: 1.72). 11/2008; 9:144. DOI: 10.1186/1471-2474-9-144
Source: PubMed


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.
We 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).
Reports 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).
Results 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.

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Available from: Lilli Kirkeskov, Dec 09, 2014
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    • "Thun et al. (1987) concluded that " workers who kneel to perform their jobs inflict chronic trauma to their knee joints. " Carpet layers are at an increased risk for a variety of knee disorders, including cartilage damage due to frequent and prolonged kneeling and squatting in addition to the use of a knee kicker to stretch carpet (NIOSH, 1990; Habes et al., 1994; Thun et al., 1987; Rytter et al., 2008; Holmstrom et al., 1995). The risk for development of knee osteoarthritis is also increased in occupations requiring kneeling, squatting , climbing, and heavy physical workloads (Manninen et al., 2002; Schneider, 2001). "
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    ABSTRACT: Euler angle decomposition and inverse dynamics were used to determine the knee angles and net forces and moments applied to the tibia during kneeling and squatting with and without kneepads for 10 subjects in four postures: squatting (Squat), kneeling on the right knee (One Knee), bilateral kneeling near full flexion (Near Full) and bilateral kneeling near 90° flexion (Near 90). Kneepads affected the knee flexion (p = .002), medial forces (p = .035), and internal rotation moments (p = .006). Squat created loading conditions that had higher varus (p < .001) and resultant moments (p = .027) than kneeling. One Knee resulted in the highest force magnitudes and net moments (p < .001) of the kneeling postures. Thigh-calf and heel-gluteus contact forces decreased the flexion moment on average by 48% during Squat and Near Full.
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    ABSTRACT: The objective of this study was to conduct a systematic review of the literature examining the association between occupational physical demands and meniscal tears. A comprehensive literature search involving electronic databases (Medline, Embase, Cinahl, Web of Science, and Cochrane) was conducted along with the reference list of relevant publications. Peer-reviewed full-text articles published in English, German, or Scandinavian languages and concerning the incidence or prevalence of knee disorders, particularly meniscal pathology in different occupational trade groups, comprised the search criteria. Studies were assessed by their quality and the evidence of a causal relationship between occupational physical activity and meniscal tears evaluated using specific criteria for different levels of evidence. By merging results from the databases, a total number of 13 nonduplicate articles were found. The majority focused on occupational knee demands among workers in the construction and mining industry. Studies showed an increased prevalence of meniscal tears among workers with kneeling and squatting work tasks. The literature search revealed few relevant articles concerning the topic, and only three articles reached the level of high quality. It is concluded that evidence is still lacking of a causal relationship between occupational physical activities and meniscal tears.
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