Age-related changes in the knee meniscus.

Background: Aging is the most prominent risk factor for the development of osteoarthritis (OA), which affects knees and causes major health burdens. Meniscal dysfunction mostly based on degeneration contributes to the development and progression of knee OA. Meniscal degeneration is caused by various extrinsic factors, such as repetitive trauma or leg malalignment, while meniscal aging is considered as internal changes, such as molecular or cellular changes. Little is known about age-related changes in the meniscus. Therefore, this review aimed to summarize and clarify the understanding of the aged meniscus.

Methods: There are few articles about natural aging in the meniscus, because most reports only demonstrate the effects of OA on the meniscus. We searched PubMed (1948 to November 2016) to identify and summarize all English-language articles evaluating natural aging in the meniscus.

Results: There is evidence of compositional change in the meniscus with aging, involving cells, collagens, and proteoglycans. In addition, as recent reports on the natural aging of cartilage have indicated, senescence of the meniscal cells may also lead to disruption of meniscal cells and tissue homeostasis. Due to the low turnover rate of collagen, accumulation of advanced glycation end-products largely contributes to tissue stiffness and vulnerability, and finally results in degenerative changes or tears. Furthermore, environmental factors such as joint fluid secreted by inflamed synovium could also contribute to meniscal tissue deterioration.

Conclusions: Age-related changes induce meniscal tissue vulnerability and finally lead to meniscal dysfunction.