Blog post produced and written by Clinic Manager and Sports Injury Specialist Jason Dodd.
This week I want to share with you an interesting study by Horga, et al, which has just been released this month. The study looked at 115 individuals where they scanned each knee (230 altogether). The key thing to note in this study too was that the average age of all participants was 44 years old AND none of the participants currently had pain or any history of pain in their knees. It was also required that participants were not to have had previous knee injuries (which we know can be a risk factor for the development of things such as knee OA).
And the results were pretty remarkable. Out of the 230 knees scanned, 97% came back with some abnormality which was highlighted as a clinical change. Let’s not forget here though, NONE of the participants have ever had pain or currently in pain.
This is supported with the study by Zanetti et al, which looked at 100 symptomatic knees and 100 asymptomatic knees (so each individual had one painful knee and one ‘happy’ knee). Again the mean age was 43 years old. They found meniscus tears in 57 painful knees and 36 tears in non-painful knees. They concluded ‘Horizontal or oblique meniscal tears are frequently encountered in both asymptomatic and symptomatic knees and may not always be related to symptoms’.
So why is this relevant? We see many people who have had MRI scans as a result of pain and they often come back with what is described as ‘abnormal findings’, but are these findings as abnormal as we may think? Often, pain develops as a result of a variety of factors which sometimes are totally unrelated to the structural integrity of the area in question. This study is a great example of changes unrelated to pain.
This is not to say that we should throw all MRI findings out of the window and disregard them, however, it does call into question the necessity for surgical intervention at such an early stage. This may help to explain why some surgical procedures are no better than sham surgery and can actually make the situation worse. You may even know someone who has had surgery and it resulted in worse outcomes….maybe this study here is an example of suspected findings not correlating to pain.
We are also not proposing that we have the answer and solution either. Studies like these are here to help us understand more about how our body works and to guide us towards the best pathway for each individual. If you, or anyone else you know is considering a surgical route and would like to gain a second opinion before proceeding then please do ask them to get in touch with us. Our links with some of the top orthopaedic clinics in London mean we can seek further advice elsewhere if needed should we require another opinion.
So next time you get that MRI report back, consider these study’s before making any future decisions.
- Zanetti, M., Pfirrmann, C.W.A., Schmid, M.R., Romero, J., Seifert, B. and Hodler, J. (2003). Patients with Suspected Meniscal Tears:Prevalence of Abnormalities Seen on MRI of 100 Symptomatic and 100 Contralateral Asymptomatic Knees. American Journal of Roentgenology, 181(3), pp.635–641.
- Horga, L.M., Hirschmann, A.C., Henckel, J., Fotiadou, A., Di Laura, A., Torlasco, C., D’Silva, A., Sharma, S., Moon, J.C. and Hart, A.J. (2020). Prevalence of abnormal findings in 230 knees of asymptomatic adults using 3.0 T MRI. Skeletal Radiology.
