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

<b>Background/Objectives</b>: This is the first study to examine age-related patterns of meniscal/chondral lesions in women undergoing first-time knee arthroscopy. <b>Methods</b>: We analyzed meniscal tear type/location and evaluated cartilage damage in femoral condyles and the tibial plateau in a medium-sized Romanian cohort (<i>n</i> = 241). <b>Results</b>: Age was associated significantly (<i>p</i> ≤ 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 (<i>p</i> < 0.001, Cramér's V = 0.32). Bucket-handle tears-the most common tear type-peaked in middle age (<i>p</i> < 0.001, Cramér's V = 0.30). The two menisci showed different distributions of tear patterns in women aged ≥40 years (<i>p</i> ≤ 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 (<i>p</i> = 0.020, Cramér's V = 0.28). The medial femoral condyle and medial tibial plateau showed significant intergroup differences in ICRS scores (<i>p</i> ≤ 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. <b>Conclusions</b>: 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.