Do asymptomatic marathon runners have an increased prevalence of meniscal abnormalities? An MR study of the knee in 23 volunteers.

Excessive repetitive musculoskeletal loads and stresses associated with intense physical activity may lead to deterioration of the menisci of the knee. Therefore, MR imaging was performed on the knees of 23 asymptomatic marathon runners (eight men, 15 women; average age, 40 years; average number of years training, 10; average training distance per week, 41 miles) to determine the prevalence of meniscal signal abnormalities. None of the runners had previous knee injuries or surgery and each of them regularly competes in 26-mile, 50-mile, or 100-mile marathon races. T1-weighted coronal MR images and proton density-weighted and T2-weighted sagittal images were obtained with a 1.5-T MR system and a transmit/receive extremity coil. The medial and lateral menisci were divided into four portions, or horns, and a total of 92 horns were evaluated (i.e., four horns per knee: medial posterior, medial anterior, lateral posterior, and lateral anterior). Two meniscal horns (2%) had grade 3 signal (grade 3 indicates a meniscal tear), 12 (13%) had grade 2 signal, 29 (32%) had grade 1 signal (grades 1 and 2 are indicative of meniscal degeneration), and 49 (53%) had grade 0 signal (grade 0 is normal). Overall, the prevalence of meniscal tears was 9% (two meniscal tears found in 23 runners). This is lower than the prevalence of MR signal abnormalities indicative of meniscal tears reported for asymptomatic, nonrunner athletes (20% of 20 athletes) and for asymptomatic nonathletes (16% of 74 subjects). Fifty-three percent of the meniscal horns of the nonrunner athletes had grade 1 or 2 signal, indicative of meniscal degeneration. Our results indicate that the prevalence of meniscal tears in marathon runners is no higher than the prevalence reported for sedentary persons, and the runners have the same amount of meniscal degeneration as do nonrunner athletes.