Arno S et al. – Cartilage loss initially occurred where there was direct contact between the cartilage of the femur and tibia. The meniscus did not prevent this, nor prevent the spread of the wear medially. This may have been due to the progressive reduction of cartilage–meniscal contact as the meniscus subluxed or lost substance, as the cartilage loss and deformity progressed. This suggested that the meniscus was not able to ameliorate the forces and pressures on the cartilage surfaces to prevent degeneration.