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BMJ Open. 2019 Dec 15;9(12):e031549. doi: 10.1136/bmjopen-2019-031549.

Influence of severe knee pain, meniscus surgery and knee arthroplasty on physical ability: an observational study of 114 949 adults in the CONSTANCES cohort.

Valter R1,2,3, Godeau D4,5, Leclerc A6, Descatha A2,3,6,7, Fadel M8,2,3.

Author information

Occupational Health Unit, Poincaré University Hospital, AP-HP (Paris Hospital) UVSQ, Garches, Île-de-France, France.
UMS 011, UMR-S 1168, Versailles St-Quentin Univ - Paris Saclay Univ, Versailles, Île-de-France, France.
VIMA : Aging and chronic diseases. Epidemiological and public health approaches, U1168, Inserm, Villejuif, F-94807, Île-de-France, France.
Occupational and Environmental Diseases Unit, AP-HP (Paris Hospital) Hôpital Avicenne, University hospital Paris Seine-Saint-Denis, Bobigny, F-93009, Île-de-France, France.
Paris 13 University Sorbonne, Paris, Île-de-France, France.
UMS 011 Population-based Epidemiologic Cohorts Unit, Inserm, Villejuif, Île-de-France, France.
Irset (Institut de recherche en santé, environnement et travail) - UMR_S1085, Univ Angers, CHU Angers, Univ Rennes, Inserm, Angers, F-49000, Pays de la Loire, France.
Occupational Health Unit, Poincaré University Hospital, AP-HP (Paris Hospital) UVSQ, Garches, Île-de-France, France



The knee is one of the major sites of musculoskeletal pain, yet few large-scale studies have evaluated the impact of knee disorders on physical limitations. Our objective was to describe this impact in a large-scale population study.


We included subjects of working age from the CONSTANCES cohort, from its inception. Four groups were distinguished according to their medical history: whether they had knee arthroplasty (KA), meniscus surgery, severe knee pain, or none of these. Outcomes assessed for physical limitations were self-reported limitations in the last 6 months due to health problems, limitation on carrying 5 kg on 10 m and a 3-metre length rapid gait speed test (for participants aged >45). Associations between knee groups and patients' characteristics and physical limitations were analysed using logistic regression. Robust associations were deemed relevant if their ORs were higher than 2 and their p value lower than 0.0001.


Of the 114 949 individuals, 99 052 (86.2%) were in the 'no pain and no surgery' group, 14 740 (12.8%) were in the severe knee pain group, 1019 (0.89%) had meniscus surgery and 138 (0.12%) had KA. Severe knee pain and KA groups showed a similar profile (they were less at work, reported more deterioration in their health and had more limitations).


Almost 14% of the sample had knee disorders. Subjects reporting severe knee pain or who had KA reported more important physical limitations then subjects who reported neither severe knee pain nor knee surgery.


knee; occupational; pain; self-reported health; surgery

Conflict of interest statement

Competing interests: The authors have no relevant conflicts of interest. They are paid by their affiliations. Alexis Descatha has received fees from Elsevier Masson as editor-in-chief of the journal 'les archives des maladies professionnelles et de l’environnement'.

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