Patterns of Meniscal Injuries in Adults Aged 35 and Older: A Retrospective Analysis of Surgical Cases

<i>Background and Objectives</i>: Knee joint injuries incur substantial healthcare and socioeconomic burdens worldwide. The connection between various demographic and clinical factors and meniscal injury patterns in patients undergoing surgery for meniscal rupture remains underexplored, especially in Eastern European cohorts. This study aimed to determine the influence of age, sex, and history of previous meniscal rupture on the patterns and types of knee joint injuries in adults aged 35 years and older undergoing surgery. <i>Materials and Methods:</i> A single-site exploratory retrospective analysis was conducted on 420 Romanian patients. The age of 35 years was selected as a cut-off for recruiting patients, as it marks the typical age at which early degenerative changes in the musculoskeletal system begin to emerge. Nonparametric/frequency analysis was applied to datasets stratified based on injury type-medial meniscal damage (MMD), lateral meniscal damage (LMD), and any patellar damage (APD). Logistic regression was used to determine influential predictors, including age, sex, and history of meniscal rupture. <i>Results</i>: Surgery was performed at a significantly younger age in patients with previous meniscus rupture (<i>p</i> < 0.001), but at a significantly older age in patients with co-occurring patellar lesions (<i>p</i> = 0.048). Men tended to be younger at the time of first surgery or any reoperations (<i>p</i> = 0.054) and displayed LMD significantly more often than MMD (<i>p</i> = 0.023). Significant differences existed in the distribution of different tear types in LMD (<i>p</i> < 0.001) and MMD (<i>p</i> < 0.001), with bucket handle tears and parrot beak tears being the most common. Male sex was associated with significantly higher odds of LMD (<i>p</i> = 0.046). Patients with previous meniscal rupture had a significantly and approximately threefold higher likelihood of presenting with MMD (<i>p</i> = 0.003). <i>Conclusions</i>: Age, sex, and history of meniscal rupture significantly influence the patterns and prevalence of knee injuries in adults aged 35 years and older. These findings reveal a dynamic interplay between demographic factors and knee joint pathologies, providing a foundation for targeted prevention and treatment strategies. Future studies should expand to larger, diverse populations to refine these insights.