HISTOMORPHOLOGICAL AND MORPHOMETRIC CHARACTERISTICS OF AGE-RELATED CHANGES IN KNEE MENISCI IN WOMEN: A COMPARATIVE STUDY

Abstract

Background: Age-related degeneration of the knee menisci is a major contributor to knee osteoarthritis, which disproportionately affects women, particularly after menopause. Systematic histomorphological and morphometric characterisation of meniscal ageing in women remains insufficiently studied in Central Asian populations. Objectives: To characterise histomorphological and morphometric features of age-related changes in the knee menisci of women across reproductive and post-reproductive age groups in Uzbekistan. Materials and Methods: A prospective cross-sectional study was conducted at the Branch of the Republican Specialized Scientific and Practical Medical Centre of Traumatology and Orthopaedics (Khorezm Regional Multidisciplinary Medical Centre). Meniscal specimens were obtained from 112 women stratified into four age groups: Group I (25–44 years, n=28), Group II (45–54 years, n=30), Group III (55–64 years, n=28), and Group IV (65–78 years, n=26). Specimens were stained with haematoxylin-eosin, Masson's trichrome, and Safranin-O/Fast Green. Morphometric parameters included fibrochondrocyte density (cells/mm²), collagen fibre alignment index (CFAI), and proteoglycan optical density (SafO-OD) measured by digital image analysis. Results: Fibrochondrocyte density declined significantly from 47.3±5.8 cells/mm² (Group I) to 20.1±4.4 cells/mm² (Group IV; p<0.001). CFAI increased from 11.9°±2.7° to 42.8°±7.3° (p<0.001), indicating progressive collagen disorganisation. Inner zone SafO-OD declined by 66% between Groups I and IV (0.90±0.08 vs. 0.31±0.06; p<0.001). The most rapid deterioration occurred between Groups II and III, corresponding to the perimenopausal decade. Medial menisci showed significantly greater degeneration than lateral menisci (p<0.05). Conclusions: Age-related meniscal degeneration in women from Khorezm region follows a progressive, zone-specific trajectory with accelerated deterioration during the perimenopausal period, providing a morphological basis for the elevated osteoarthritis risk in postmenopausal women.