The Ageing Meniscus: Pathophysiology, Epidemiology And Management
As we age, our bodies naturally change, and our knees are no exception. A key component of knee health is the meniscus, a C-shaped cartilage that acts like a shock absorber, distributing weight and stabilizing the joint. Over time, the meniscus experiences a decline in its strength and biochemical makeup. This includes processes like “cellular senescence,” where cells stop dividing and accumulate, and the buildup of “advanced glycation end-products,” which are harmful compounds that can stiffen tissues.
These age-related changes can lead to structural damage, often seen as horizontal tears or “cleavage lesions.” Interestingly, these are often more like natural “wrinkles” in the meniscus rather than acute injuries, and they frequently don’t cause any pain or symptoms. They might even show up on an MRI without the person knowing they have them.
For those who do experience pain or mechanical issues from an aging meniscus, the focus of management has shifted. Instead of immediately considering surgery, doctors now often recommend conservative approaches. These can include exercise therapy to strengthen the surrounding muscles, optimizing your metabolism, nutritional supplements, using devices to reduce stress on the knee (biomechanical offloading), and injection-based treatments. Surgery is generally considered a secondary option, reserved for individuals with persistent symptoms or significant structural problems.
Source: link to paper