The Impact of Aging on Meniscal Tears and Chondral Lesions in Men: Insights from First-Time Arthroscopic Knee Evaluation

(1) Background: This is the first study investigating the age-related distribution of meniscal and chondral lesions in an all-male cohort undergoing first-time knee arthroscopy. (2) Methods: The study population included 876 adult men stratified into five decade-based age groups. Lesions were confirmed arthroscopically after MRI evaluation, with chondral injuries being graded using the ICRS system. (3) Results: The frequency of medial meniscal tears differed significantly across age strata (<i>p</i> = 0.042), increasing with age. No differences were detected for lateral meniscal damage or patellar damage. Age was a significant predictor of medial meniscal damage (OR = 1.04; <i>p</i> = 0.003), but not for other types of knee injuries. Medial meniscal damage correlated with patellar damage (men < 30, 50-59) and inversely with lateral damage (30-39); other correlations were non-significant. Chondropathy severity increased significantly with age in the medial femoral condyle and medial tibial plateau (<i>p</i> < 0.001), with severe (ICRS grade IV) lesions showing a steep rise after 60 years. Cartilage lesions at the level of the lateral knee compartment were, by contrast, less prevalent and less severe, with no significant variation across age groups. (4) Conclusions: These findings demonstrate that intra-articular knee pathology in men shifts with age, with medial compartment degeneration becoming increasingly prominent.