Potential sources of pain in symptomatic degenerative meniscal tear: A narrative review

Abstract

Importance

Although degenerative meniscal tear is relatively prevalent in older persons, the sources of the accompanying pain and mechanical symptoms—such as knee clicking, locking, and popping—are unclear, making targeted treatment difficult. We conducted a narrative literature review to synthesize research surrounding sources of symptomatic degenerative meniscal tear.

Observations

We identified five mechanisms of symptom generation in patients with degenerative meniscal tear: obstruction, abnormal load bearing, inflammation, neoinnervation, and central sensitization. We confirmed clinical observations that degenerative meniscal tear often occurs concomitantly with knee osteoarthritis, which adds complexity to symptom attribution.

Conclusions and relevance

Degenerative meniscal tear may lead to pain or mechanical symptoms through a variety of pathways. In identifying the diversity in pathways and corresponding physiological changes leading to symptomatic degenerative meniscal tear, this review may help clinicians contextualize the condition and target therapies for their patients.