## 4 Discussion  
The current investigation identified age as a significant predictor of the risk for medial meniscal tears but not for lateral meniscal tears. This finding aligns with the existing orthopedic literature [6; 28; 34]. For example, [PERSON] et al. found that longer time to surgery was associated with a higher prevalence of medial meniscal damage in 1434 patients undergoing anterior cruciate ligament (ACL) reconstruction--suggesting that both age and surgical delay contribute to degenerative progression. In contrast, no relationship was found for lateral meniscus tears [34]. [PERSON] et al. reported comparable outcomes for 764 patients undergoing first-time arthroscopic treatment for ACL tears [28]. Similarly, [PERSON] et al. revealed an age-dependent increase in the prevalence of isolated medial meniscus tears within a cohort of 782 individuals [6]. Greater age-related degeneration in the medial meniscus [35] may be explained by its distinct biomechanical and anatomical properties. The medial meniscus is subjected to greater compressive and shear forces during weight-bearing activities (e.g., walking, running, jogging, hiking, dancing, stair climbing, tennis, basketball, squats, lunges) because of its connection to the medial collateral ligament and its less mobile nature compared with the lateral meniscus [35; 36; 37]. Despite an obvious trend of age-dependent increase in the prevalence of medial meniscal tears, a significant rise was observed only from the third age quartile onward, corresponding to individuals aged 33 years and older. Indeed, a recent study reported that meniscal tears are more common than previously identified, particularly in patients over 30 years old [38]. In a study of surgically treated patients, isolated medial meniscal tears were also more common in individuals over 30 years of age, with 52.2% of such tears \begin{table}
\begin{tabular}{c c c} \hline \hline
**Variable** & **LMD** & **KAD** \\ \hline  & **Q1** & \\ \hline MMD & 0.42 * & 0.21 \\ LMD & & 0.18 \\ \hline  & **Q2** & \\ \hline MMD & 0.55 * & 0.38 * \\ LMD & & \(-0.12\) \\ \hline  & **Q3** & \\ \hline MMD & 0.50 * & 0.30 * \\ LMD & & 0.25 \\ \hline  & **Q4** & \\ \hline MMD & 0.60 * & 0.40 * \\ LMD & & 0.15 \\ \hline \hline \end{tabular}
\end{table} 
Table 4: Correlations among different types of knee joint injuries in age quartiles. occurring in this age group [6]. In addition, meniscal tears significant enough to warrant treatment are 2-3 times more frequent after the fourth decade of life [39]. Moreover, the prevalence of medial meniscal injuries increases with age, reaching 50% in adults over 70 years old, suggesting a degenerative etiology [40]. These observations are consistent with the timeframe during which the frequency of medial meniscus injuries begins to rise in our study. Most probably, these data reflect the combined effect of cumulative mechanical stress and biological aging processes. Age-related changes in the meniscus, e.g., cellular senescence, reduced proteoglycan content, decreased collagen cross-linking, and the accumulation of advanced glycation end products, contribute to meniscus stiffness and vulnerability, making it more susceptible to damage [41]. No significant association was found between age and lateral meniscal rupture, with quartile-based analysis revealing no meaningful differences across the age groups. Lateral meniscal injuries may, hence, be more strongly related to acute trauma, such as sports injuries or high-impact activities, rather than gradual degeneration. This may be related to the anatomical position and greater mobility of the lateral meniscus, which reduce its exposure to chronic stress but increase its vulnerability to rapid rotational movements or valgus forces [42]. In fact, [PERSON] et al. reported that lateral meniscal injuries are disproportionately higher in younger, active populations involved in pivot-heavy sports, such as soccer or basketball, where acute traumas are more common [43].