No detectable remodelling in adult human menisci: an analysis based on the C14 bomb pulse

Br J Sports Med. 2020 Dec;54(23):1433-1437. doi: 10.1136/bjsports-2019-101360. Epub 2020 May 14.


Objectives: Bone and other human tissues remodel through life, for example, as a response to increasing load, and this prevents permanent destruction of the tissue. Non-traumatic meniscal rupture is a common musculoskeletal disease, but it is unknown if it is caused by inability of the menisci to remodel. The aim of this study was to determine whether meniscal collagen is remodelling throughout life.

Methods: The life-long turnover of the human meniscal collagens was explored by the 14C bomb pulse method. 14C levels were determined in menisci from 18 patients with osteoarthritis and 7 patients with healthy knees.

Results: There was a negligible turnover of the meniscal collagen in adults. This low turnover was observed in menisci from patients with knee osteoarthritis and in healthy menisci.

Conclusion: This study provides evidence that essentially no remodelling occurs in the adult human meniscal collagen structure and explains the clinical degeneration that is often seen in menisci of middle-aged and elderly persons. It suggests that strengthening of the collagen structure of menisci, as response to physical activity, may occur during childhood, while it is not possible in the adult population.

Keywords: collagen; meniscus; metabolism.

MeSH terms

  • Adult
  • Body Water / metabolism
  • Carbon Radioisotopes
  • Collagen / metabolism*
  • Glycosaminoglycans / metabolism
  • Humans
  • Hydroxyproline / metabolism
  • Menisci, Tibial / chemistry
  • Menisci, Tibial / metabolism*
  • Menisci, Tibial / physiopathology
  • Osteoarthritis, Knee / metabolism
  • Osteoarthritis, Knee / physiopathology
  • Weight-Bearing


  • Carbon Radioisotopes
  • Glycosaminoglycans
  • Collagen
  • Hydroxyproline