The meniscofemoral ligaments influence lateral meniscal motion at the human knee joint.
ABSTRACT The purpose of this study was to investigate the effect of the meniscofemoral ligaments on lateral meniscal motion during flexion and extension of the human knee joint.
A cadaveric biomechanical study was performed. The effect of meniscofemoral ligament tension on the dynamics of the posterior horn of the lateral meniscus was determined by image analysis.
We found that the meniscofemoral ligaments functioned in a reciprocal manner, with the anterior meniscofemoral ligament developing tension with flexion and the posterior meniscofemoral ligament tensioning with extension. Analysis of posterior horn motion showed that the meniscofemoral ligaments caused a medial, superior, and anterior displacement of the posterior horn throughout knee motion, thus increasing the congruity of the posterior meniscal arch and the lateral femoral condyle. There was a significant correlation between meniscofemoral ligament tension and displacement of the posterior meniscal horn (r = 0.76, P < .0001).
Where both meniscofemoral ligaments were present, the posterior horn of the lateral meniscus was subject to a displacing force throughout the range of knee motion tested. The degree of displacement correlated with the magnitude of ligament tension, and its direction was anteromedial and superior.
The findings of this study provide further information on the role of the meniscofemoral ligaments at the human knee joint and may influence decisions regarding the management of ligamentous or lateral meniscal injury.
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ABSTRACT: PURPOSE: Translation during knee flexion is a key function of the menisci. The amount of translation displayed by the medial and lateral meniscus during knee flexion, particularly while loadbearing, remains relatively unknown. To address this lack of knowledge, a systematic review of the relevant literature was performed. METHODS: We performed a literature search for studies in which a primary aim was to report the anterior-posterior translation of the menisci during knee flexion. Data were collected on the characteristics of the sample, the imaging approach, measurement and analysis techniques, and outcome variables. We scored the quality of studies and their reporting using a modified Coleman methodology score with ten criteria, with a maximum possible score of 100. RESULTS: Twelve full-text studies were retrieved that met the inclusion criteria. Of these, the in vitro studies (N = 4) scored the lowest for methodology (median 44.5), with in vivo studies of healthy knees (N = 4) (median 60) and in vivo comparative studies (N = 4) scoring highest (median 74.5). The evidence from studies with the highest methodology scores (>65) (N = 4) indicate that the lateral meniscus translates more posteriorly than the medial meniscus during flexion. In addition, meniscal translation is influenced by loading, particularly in knee rotation, but not by ACL deficiency, despite greater posterior translation of the medial femoral condyle during flexion. CONCLUSIONS: The generally low methodological quality of studies suggests that caution is required when interpreting meniscal translation during knee flexion reported in the literature. While the methods for assessing meniscal translation in vivo continue to improve and provide opportunity for clinical implementation, there remains a lack of robust evidence regarding meniscal translation in the healthy knee for comparative purposes. A number of recommendations are made for future studies to address key limitations identified in previous investigations. Additional studies of high methodological quality are required to quantify the relationships between joint loading, joint pathology and meniscal translation during knee flexion. LEVEL OF EVIDENCE: III.Knee Surgery Sports Traumatology Arthroscopy 04/2013; 23(1). DOI:10.1007/s00167-013-2482-3 · 2.68 Impact Factor
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ABSTRACT: To alert the treating clinician to an uncommon knee meniscal condition that often masquerades as a more common patella condition. Retrospective chart review of a series of cases was undertaken. A series of 12 knees in 11 patients were referred to an orthopaedic surgeon with a diagnosis of recurrent lateral patella dislocation. Three knees had undergone patella realignment surgery with continuance of symptoms. Eight patients had prior magnetic resonance images read as no meniscal pathology and no acute patella/patella retinacular injury. All patients presented for a consult with a similar history. Under anaesthesia, all knees had a stable patella as judged by physical examination. At the time of surgery, six patients had a frank tear in the lateral meniscus, all of which were readily displaceable. Six knees showed a displaceable lateral meniscus with attenuation but not a visible frank tear. Ten menisci were treated with repair, and two knees underwent partial lateral meniscectomies. Patient follow-up of minimally 18 months revealed no further episodes of "knee-cap dislocation" or symptoms of catching and locking. The clinician treating a patient with a history of a knee locking in flexion should have a high index of suspicion for a lateral meniscus tear or an unstable hypermobile lateral meniscus, despite patient report of perceived patella movement. History of symptoms occurring in knee flexion and attention to patella physical examination should be key factors in this diagnostic conundrum. Retrospective chart review, Level IV.Knee Surgery Sports Traumatology Arthroscopy 10/2013; 22(10). DOI:10.1007/s00167-013-2729-z · 2.68 Impact Factor
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ABSTRACT: Although there have been some attempts to reveal the anatomy of the posterior root of the lateral meniscus (PRLM) through cadaver studies, arthroscopy, or imaging, it has not yet been described fully. To describe clearly the unique features of the PRLM, including its course, configuration, and size, using 3.0-T magnetic resonance imaging (MRI). A total of 105 knee 3.0-T MR examinations of 103 patients with arthroscopically proven intact PRLM were reviewed retrospectively. Based on fat-saturated, proton-density-weighted (PDW) axial/coronal images and PDW sagittal images, the course, configuration, and attachment sites of the PRLM were evaluated. The majority of PRLM (76.2%) had two attachment sites: the medial tubercle along the intertubercular crest, just posteromedial to the tibial attachment of the anterior cruciate ligament (ACL), and the posterior slope of the lateral tubercle. The remaining cases (23.8%) had a solitary insertion on the intertubercular area (17 cases), or the posterior slope of the lateral tubercle (eight cases). The PRLM of the intertubercular area appeared as a dark signal line parallel to the tibial plateau on the mid-sagittal image and dark signal foci traversing the intertubercular crest on contiguous coronal images. The PRLM inserts mainly in the intertubercular area with a thin, long anterior extension to the point just posteromedial to the tibial attachment of the ACL. It is well delineated on PDW 3.0-T MRI as a dark signal line parallel to the tibial plateau on mid-sagittal images and dark signal foci traversing the intertubercular crest on contiguous coronal images.Acta Radiologica 08/2013; 55(3). DOI:10.1177/0284185113496677 · 1.35 Impact Factor