## 4 Discussion
On the other hand, weaker correlations with meniscal damage across all quartiles suggest meniscal injuries are generally distinct, with a modest age-related association  
The design and scope of this research provides valuable insights into meniscal injuries and associated knee chondopathies. First, the exclusive focus on first-time meniscal surgery enables a more accurate epidemiological and anatomical characterization of injury patterns before any surgical or postoperative changes alter tissue integrity. This, in turn, allows a clearer interpretation of natural disease progression. Second, the use of age quartiles uncovers trends that could be masked by analyzing the age continuum or isolated age groups. This approach delivers a refined understanding of the non-linear relationship between age and meniscal injuries. Third, the focus on age and sex as predictors increases the generalizability and clinical utility of the findings, especially in settings with inconsistent data on BMI, physical activity, or comorbidities. Finally, these findings help bridge the geographic and demographic gaps in the orthopedic literature by including a large cohort from an underrepresented Eastern European population. This study offers practical insights that can directly inform clinical decision making and patient management strategies. Age-dependent increases in meniscus tears encourages earlier imaging and preventive strategies in aging populations. The marked rise of chondropathy in young adulthood emphasizes the need for early detection/intervention in young adults to prevent progression. The strength of the correlation between medial meniscal tears and chondropathy increased with age. This trend favors the inclusion of cartilage status in preoperative assessments for meniscal surgery. Moreover, these findings support sex-specific risk assessment and treatment planning, as lateral meniscal tears were more prevalent in men and did not show an association with age. Despite its strengths, this study--like all observational research--has several limitations that should be acknowledged. One can argue that a major limitation of this study is the focus on age and sex. These variables are often the strongest, most universal, and clinically relevant predictors for injury patterns and disease progression in orthopedic research [6; 12; 14; 15]. However, other factors--especially BMI and physical activity--play key roles in knee joint biomechanics and injury risk [4; 5; 8; 11; 14; 31]. The intentional decision to exclude these parameters from regression models was based on our aim to focus on universally available clinical variables--age and sex--that are easily accessible in all healthcare settings [1; 3; 35]. Since BMI and physical activity levels were not consistently documented across the medical records, their inclusion would also have introduced significant data heterogeneity and risk of selection bias. Moreover, the simplicity of this approach enhances the clinical applicability of the present findings while avoiding overfitting and statistical noise. Nevertheless, we acknowledge the exclusion of these factors as a drawback and encourage future prospective studies to explore the interactive role of lifestyle and metabolic factors in meniscal pathology. Since this study was run at a single-center facility in Eastern Europe, it is not representative of different healthcare frameworks, surgical methods, or patient populations. While the sample is region-specific, the methodology applied is robust and can be extrapolated to other international studies to assess broader applicability. The present investigation also analyzes only patients having first-time meniscal surgeries without determining long-term outcomes, re-injury rates, or progression to osteoarthritis. Nonetheless, this focus on unaltered pathology reflects natural injury progression without the bias introduced by prior surgical interventions. Moreover, it lays the groundwork for future longitudinal studies, identifying key trends that warrant long-term monitoring.