A postal survey of working age men found that 54% had ever had any knee symptoms, mostly pain and stiffness, and 14% had had to miss time from work because of it. Those whose jobs involved kneeling or squatting were more likely to have seen an orthopaedic surgeon. Meniscal injury was reported more often in those who played soccer and rugby and in those whose jobs involved kneeling, squatting, and frequent climbing of stairs.

The postal questionnaire was sent to a random sample of men aged 20–59. They were asked for their occupational and sporting history and history of knee symptoms lasting 24 hours or longer. The association of knee cartilage injury with sport and occupation was looked at by comparing all those who reported undergoing menisectomy with five randomly selected age-matched controls.

A total of 1404 men completed the survey (50% response rate). Although 31% had seen a general practitioner about their knee symptoms, only 13% had seen an orthopaedic surgeon. These men were more likely to be in jobs involving kneeling or squatting. Only 4.8% had undergone a menisectomy and a strong association was found with playing soccer and rugby and having a job involving kneeling, squatting and frequent climbing of stairs.

Findings from a community based survey such as this avoid the bias inherent in hospital studies. Although the response rate was low and the study subject to recall bias, it does show that hospital referral for knee symptoms is influenced by patients’ occupational activities.