Skip to main content

Advertisement

Log in

Medial Knee Joint Space in Relation to Joint Function and Early Knee Pain in 20–45-Year Adults: A Cross Sectional Study

  • Original Article
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Background

Anterior knee pain is very common in the young and active age groups but there are no significant studies on the normal population. Therefore, the objective of the study was to understand the relation between medial knee joint space to the development of knee pain and functional disability with special reference to the 20–45-year age group.

Materials and methods

250 cases with mean age of 36.36 years presenting with knee pain for at least 1 month were included in this prospective study (July 2021 and June 2022) and were asked to self-complete questionnaires on knee pain which included KNEST, AKPQ, VAS and IPAQ. Patients underwent X-rays of bilateral knees in AP view with weight bearing and then medial and lateral knee joint spaces were calculated.

Results

There was a higher incidence of knee pain in women compared to men. The average medial and lateral joint space widths (MJSW and LJSW) of the right knee were 4.22 mm and 4.57 mm, respectively. For the left knee it was 4.19 mm and 4.42 mm, respectively. There is a decrease in MJSW with increasing age, level of pain and BMI. Also, with an increase in physical activity, there was a higher incidence of knee pain.

Conclusion

Overuse injuries are the main cause of knee pain in this age group. There is a significant association between medial joint space width and age, gender, level of pain, and BMI. Rising BMI patterns at a young age, leads to an increase in physical activity, which in turn leads to early knee pain and also predisposes to osteoarthritis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Roush, J. R., & Bay, R. C. (2012). Prevalence of anterior knee pain in 18–35 year-old females. International Journal of Sports Physical Therapy, 7, 396.

    PubMed  PubMed Central  Google Scholar 

  2. Baker, P., Reading, I., Cooper, C., & Coggon, D. (2003). Knee disorders in the general population and their relation to occupation. Occupational and Environmental Medicine, 60, 794–797.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Silverwood, V., et al. (2015). Current evidence on risk factors for knee osteoarthritis in older adults: A systematic review and meta-analysis. Osteoarthritis and Cartilage, 23, 507–515.

    Article  CAS  PubMed  Google Scholar 

  4. Dey, P., et al. (2016). A questionnaire to identify patellofemoral pain in the community: an exploration of measurement properties. BMC Musculoskeletal Disorders, 17, 237.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Muraki, S., et al. (2015). Joint space narrowing, body mass index, and knee pain: the ROAD study (OAC1839R1). Osteoarthritis and Cartilage, 23, 874–881.

    Article  CAS  PubMed  Google Scholar 

  6. Muraki, S., et al. (2009). Prevalence of radiographic knee osteoarthritis and its association with knee pain in the elderly of Japanese population-based cohorts: the ROAD study. Osteoarthritis and Cartilage, 17, 1137–1143.

    Article  CAS  PubMed  Google Scholar 

  7. Johnson, W., Li, L., Kuh, D., & Hardy, R. (2015). How has the age-related process of overweight or obesity development changed over time? Co-ordinated analyses of individual participant data from five United Kingdom birth cohorts. PLoS Medicine, 12, e1001828.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Difiori, J. P., et al. (2014). Overuse injuries and burnout in youth sports: a position statement from the American medical society for sports medicine. British Journal of Sports Medicine, 48, 287–288.

    Article  PubMed  Google Scholar 

  9. Patel, D. R., & Villalobos, A. (2017). Evaluation and management of knee pain in young athletes: overuse injuries of the knee. Translational Pediatrics, 6, 190–198.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Gelber, A. C., et al. (2000). Joint injury in young adults and risk for subsequent knee and hip osteoarthritis. Annals of Internal Medicine, 133, 321.

    Article  CAS  PubMed  Google Scholar 

  11. Jinks, C., Lewis, M., Ong, B. N., & Croft, P. (2001). A brief screening tool for knee pain in primary care. 1. Validity and reliability. Rheumatology (Oxford), 40, 528–536.

    Article  CAS  PubMed  Google Scholar 

  12. Kujala, U. M., et al. (1993). Scoring of patellofemoral disorders. Arthroscopy, 9, 159–163.

    Article  CAS  PubMed  Google Scholar 

  13. Crossley, K. M., Bennell, K. L., Cowan, S. M., & Green, S. (2004). Analysis of outcome measures for persons with patellofemoral pain: which are reliable and valid? Archives of Physical Medicine and Rehabilitation, 85, 815–822.

    Article  PubMed  Google Scholar 

  14. Lankhorst, N. E., Bierma-Zeinstra, S. M. A., & Van Middelkoop, M. (2012). Risk factors for patellofemoral pain syndrome: a systematic review. Journal of Orthopaedic and Sports Physical Therapy, 42, 81–94.

    Article  PubMed  Google Scholar 

  15. Maclachlan, L. R., Collins, N. J., Matthews, M. L. G., Hodges, P. W., & Vicenzino, B. (2017). The psychological features of patellofemoral pain: a systematic review. British Journal of Sports Medicine, 51, 732–742.

    Article  PubMed  Google Scholar 

  16. Anderson, G., & Herrington, L. (2003). A comparison of eccentric isokinetic torque production and velocity of knee flexion angle during step down in patellofemoral pain syndrome patients and unaffected subjects. Clinical Biomechanics (Bristol, Avon), 18, 500–504.

    Article  PubMed  Google Scholar 

  17. McConnell, J. (1996). Management of patellofemoral problems. Manual Therapy, 1, 60–66.

    Article  CAS  PubMed  Google Scholar 

  18. Witvrouw, E., et al. (2003). The effect of exercise regimens on reflex response time of the vasti muscles in patients with anterior knee pain: a prospective randomized intervention study. Scandinavian Journal of Medicine and Science in Sports, 13, 251–258.

    Article  CAS  PubMed  Google Scholar 

  19. Boling, M., et al. (2010). Gender differences in the incidence and prevalence of patellofemoral pain syndrome. Scandinavian Journal of Medicine and Science in Sports, 20, 725–730.

    Article  CAS  PubMed  Google Scholar 

  20. Kinds, M. B., et al. (2013). Quantitative radiographic features of early knee osteoarthritis: development over 5 years and relationship with symptoms in the CHECK cohort. Journal of Rheumatology, 40, 58–65.

    Article  PubMed  Google Scholar 

  21. Oka, H., et al. (2008). Fully automatic quantification of knee osteoarthritis severity on plain radiographs. Osteoarthritis and Cartilage, 16, 1300–1306.

    Article  CAS  PubMed  Google Scholar 

  22. Chan, W. P., Huang, G. S., Hsu, S. M., Chang, Y. C., & Ho, W. P. (2008). Radiographic joint space narrowing in osteoarthritis of the knee: relationship to meniscal tears and duration of pain. Skeletal Radiology, 37, 917–930.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Anas, I., et al. (2013). Digital radiographic measurement of normal knee joint space in adults at Kano. Nigeria. Egypt. J. Radiol. Nucl. Med., 44, 253–258.

    Article  Google Scholar 

  24. Beattie, K. A., et al. (2008). Minimum joint space width and tibial cartilage morphology in the knees of healthy individuals: a cross-sectional study. BMC Musculoskeletal Disorders, 9, 1–9.

    Article  Google Scholar 

  25. Richmond, S. A., et al. (2013). Are joint injury, sport activity, physical activity, obesity, or occupational activities predictors for osteoarthritis? A systematic review. Journal of Orthopaedic and Sports Physical Therapy, 43, 515–524.

    Article  PubMed  Google Scholar 

  26. Tran, G., et al. (2016). Does sports participation (including level of performance and previous injury) increase risk of osteoarthritis? A systematic review and meta-analysis. British Journal of Sports Medicine, 50, 1459–1466.

    Article  PubMed  Google Scholar 

  27. Oka, H., et al. (2010). Normal and threshold values of radiographic parameters for knee osteoarthritis using a computer-assisted measuring system (KOACAD): the ROAD study. Journal of Orthopaedic Science, 15, 781–789.

    Article  PubMed  Google Scholar 

  28. Coggon, D., et al. (2001). Knee osteoarthritis and obesity. International Journal of Obesity, 25(5), 622–627.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jehirul Ahmed.

Ethics declarations

Conflict of interest

On behalf of all the authors, the corresponding author states that there is no conflict of interest.

Ethical approval 

Not required.

Informed consent

Informed consent has been taken from all participants.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Barua, D.S., Roy, V., Ahmed, J. et al. Medial Knee Joint Space in Relation to Joint Function and Early Knee Pain in 20–45-Year Adults: A Cross Sectional Study. JOIO 57, 1640–1645 (2023). https://doi.org/10.1007/s43465-023-00980-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s43465-023-00980-w

Keywords

Navigation