Study finds gender gap in knee injuries

One of the largest MRI studies comparing knee injuries by sex has found age-related differences in patterns.

The findings could be used to improve risk assessment and develop early intervention strategies.

Researchers analysed 13,549 consecutive routine knee MRI exams performed between 2019 and 2024 at four outpatient radiology facilities affiliated with Johns Hopkins Hospital in the US. All patients reported knee pain as their primary complaint.

The team extracted data on tears and injuries to key structures including the menisci, C-shaped cartilage that cushions the joint, and the anterior cruciate ligament (ACL), a major ligament that stabilises the knee during twisting, jumping and sudden direction changes.

Analysis revealed that ACL tears, both alone and combined with meniscal tears, were observed more frequently in men than women.

Ali Ghasemi, postdoctoral research fellow at Johns Hopkins, said: “We saw more ACL tears in men especially in the 20- to 40-year-old age group, which is contrary to what’s been reported in the literature.

“Prior studies focused on sports-related injuries have shown that young women athletes have increased rates of and a greater risk for ACL tears.

“However, our results show a significantly higher prevalence of ACL injuries in male patients across all age groups.”

Men had a greater number of injuries overall.

However, the researchers found that meniscal tears and injuries to the medial collateral ligament (MCL), which stabilises the inner knee, occurred more frequently in men under 40 but were more common in older women.

Ghasemi said: “In younger patients, meniscal and MCL tears were more commonly seen in men, while in older patients, women had more of these types of tears than men, which was unexpected.”

The findings suggest older women are more prone to injuries that lead to joint degeneration over time.

Study co-author Jenifer Pitman, assistant professor of radiology at Johns Hopkins Medical Institute, theorised the discrepancy between their findings and previous research may be due to broadening the focus beyond sports-related injuries.

She said: “The pre-established notion that ACL tears are more common in younger women may not be the case 100 per cent of the time.

“Radiologists can also expect to see more frequent meniscal pathology and arthritis in older women.”

Pitman advised that women over 40 should pay attention to joint health and consider strength training to protect their knees.