Which knee pathology is most strongly linked to the development of knee osteoarthritis?

• A. ACL tear
• B. PFPS
• C. PCL tear
• D. Meniscal tear

Answer: (D)

The key idea is how meniscal integrity affects knee joint mechanics and cartilage health. The menisci help distribute load across the tibiofemoral joint and convert axial load into hoop stress, protecting articular cartilage from high stresses. When a meniscal tear occurs, especially ones that disrupt hoop tension or cause extrusion, the contact area decreases and peak contact stresses increase. That abnormal loading accelerates cartilage wear and can initiate or accelerate osteoarthritis.

Other knee injuries can raise OA risk, but the link isn’t as direct or strong. ACL tears often carry OA risk, especially with associated meniscal damage, and PFPS or PCL tears don’t impact tibiofemoral cartilage loading as consistently or as severely. So the strongest association with future knee osteoarthritis is a meniscal tear.