Age-Dependent Meniscal and Chondral Damage in Eastern European Women Undergoing First-Time Knee Arthroscopy

Abstract

Background/Objectives: This is the first study to examine age-related patterns of meniscal/chondral lesions in women undergoing first-time knee arthroscopy. Methods: We analyzed meniscal tear type/location and evaluated cartilage damage in femoral condyles and the tibial plateau in a medium-sized Romanian cohort (n = 241). Results: Age was associated significantly (p ≤ 0.004) with medial meniscal damage (O.R. = 1.04, 95% CI: 1.01-1.06), medial femoral condyle chondropathy (O.R. = 1.06, 95% CI: 1.03-1.10), and medial tibial plateau chondropathy (O.R. = 1.07, 95% CI: 1.02-1.12). Medial meniscus tear patterns differed significantly between age groups (p < 0.001, Cramér's V = 0.32). Bucket-handle tears-the most common tear type-peaked in middle age (p < 0.001, Cramér's V = 0.30). The two menisci showed different distributions of tear patterns in women aged ≥40 years (p ≤ 0.023, Cramér's V ≤ 0.41). Meniscal tears most commonly involved the posterior third. The distribution of tear sites in menisci (medial vs. lateral) varied significantly in women aged 40-59 years (p = 0.020, Cramér's V = 0.28). The medial femoral condyle and medial tibial plateau showed significant intergroup differences in ICRS scores (p ≤ 0.024, Cramér's V ≤ 0.34). The frequency of ICRS grade 4 cartilage lesions increased markedly in the 40-59 age group at both sites, continuing to rise in older patients for the medial tibial plateau. Conclusions: Knee pathology in women worsens with age, especially in the medial compartment. Early screening (intervention) in middle-aged women may help prevent advanced joint damage.

Keywords: ICRS grading; age-related knee injury; cartilage lesions; chondropathy; degenerative joint disease; medial compartment; meniscal tears.

Figure 1

Heatmap showing the age-stratified distribution of chondral lesions associated with meniscal tears for the femoral condyle (left) and tibial plateau (right). Data are given as absolute values with the corresponding percentages (in parentheses). Age groups were defined as follows: <40—patients younger than 40 years; 40–59—patients aged between 40 and 59 years; ≥60—patients aged 60 years and older. MFCC, medial femoral condyle chondropathy; LFCC, lateral femoral condyle chondropathy; MTPC, medial tibial plateau chondropathy; LTPC, lateral tibial plateau chondropathy; 0, ICRS grade 0 (normal cartilage, no damage); 1, ICRS grade 1 (superficial lesions, issues, cracks, and indentations); 2, ICRS grade 2 (fraying, lesions extending down to <50% of cartilage depth); 3, ICRS grade 3 (partial loss of cartilage thickness, cartilage defects extending down >50% of cartilage depth as well as down to calcified layer); 4, ICRS grade 4 (complete loss of cartilage thickness).