Vol 80, No 3 (2021)
Original article
Published online: 2020-10-15

open access

Page views 7203
Article views/downloads 1582
Get Citation

Connect on Social Media

Connect on Social Media

Menisco-fibular ligament — an overview: cadaveric dissection, clinical and magnetic resonance imaging diagnosis, arthroscopic visualisation and treatment

U. E. Zdanowicz12, B. Ciszkowska-Łysoń1, P. Krajewski3, B. Ciszek4, S. F. Badylak1
Pubmed: 33084006
Folia Morphol 2021;80(3):683-690.

Abstract

Background: Injury to the menisco-fibular ligament (MFiL) is not commonly recognised. The anatomy of the lateral meniscus is complex and structure-function relationships are only partly understood. The purpose of the present study was to evaluate the MFiL, an anatomic structure rarely discussed that stabilises the lateral meniscus at the level of the hiatus popliteus and may have a crucial role in pathology of lateral meniscus injury.
Materials and methods: The MFiL was dissected from its attachment at the lateral meniscus to its insertion on fibular head in 12 human normal cadaver knees. The dimensions were determined and its anatomic position visualised throughout a 90° range of motion. Findings were documented on digital photographs and on video. Results were compared against the magnetic resonance imaging (MRI) appearance of the injured MFiL in 20 patients. Concomitant knee injuries in those patients were also analysed to determine the most frequent pattern of injuries.
Results: The normal MFiL showed an inverted trapezoid-shape with a mean width proximally of 13 mm, mean width distally of 8.5 mm and a mean length of 18.4 mm. MRI visualisation of the ligament was possible even in regular sequences; however, additional radial plane sequences were also used. Arthroscopic visualisation and manipulation was optimal when the camera was inserted into the postero-lateral gutter with full knee extension.
Conclusions: The MFiL stabilises the postero-lateral knee in concert with the menisco-femoral ligaments. Injury to the MFiL can be a cause of chronic postero-lateral pain syndrome with associated instability. Further anatomical and biomechanical studies are needed in order to fully evaluate its importance.

Article available in PDF format

View PDF Download PDF file

References

  1. Bozkurt M, Elhan A, Tekdemir I, et al. An anatomical study of the meniscofibular ligament. Knee Surg Sports Traumatol Arthrosc. 2004; 12(5): 429–433.
  2. Ciszkowska-Łysoń B, Zdanowicz U, Śmigielski R, et al. Underestimated Meniscofibular Ligament: Cadaveric Investigation of Anatomy with Mri Correlation. In: Abstract book 41st Congress of the Polish Medical Society of Radiology, 2 - 4 June 2016, Kraków. p. : 145–146.
  3. Covey DC. Injuries of the posterolateral corner of the knee. J Bone Joint Surg Am. 2001; 83(1): 106–118.
  4. Davies H, Unwin A, Aichroth P. The posterolateral corner of the knee. Injury. 2004; 35(1): 68–75.
  5. Haines RW. The tetrapod knee joint. J Anat. 1942; 76(3): 270–301.
  6. Jørgensen U, Sonne-Holm S, Lauridsen F, et al. Long-term follow-up of meniscectomy in athletes. A prospective longitudinal study. J Bone Joint Surg Br. 1987; 69(1): 80–83.
  7. Lee YH, Song HT, Kim S, et al. Magnetic resonance arthrographic dissection of posterolateral corner of the knee: revealing the meniscofibular ligament. Yonsei Med J. 2012; 53(4): 820–824.
  8. Natsis K, Paraskevas G, Anastasopoulos N, et al. Meniscofibular ligament: morphology and functional significance of a relatively unknown anatomical structure. Anat Res Int. 2012; 2012: 214784.
  9. Obaid H, Gartner L, Haydar AA, et al. The meniscofibular ligament: an MRI study. Eur J Radiol. 2010; 73(1): 159–161.
  10. Parsons FG. The Joints of Mammals compared with those of Man: A Course of Lectures delivered at the Royal College of Surgeons of England. J Anat Physiol. 1899; 34(Pt 1): 41–68.
  11. Quinn SF, Brown TR, Szumowski J. Menisci of the knee: radial MR imaging correlated with arthroscopy in 259 patients. Radiology. 1992; 185(2): 577–580.
  12. Seebacher JR, Inglis AE, Marshall JL, et al. The structure of the posterolateral aspect of the knee. J Bone Joint Surg. 1982; 64(4): 536–541.