Background
Injury to the menisco-fibular ligament is not commonly recognized. 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 menisco-fibular ligament, an anatomic structure rarely discussed that stabilizes 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 menisco-fibular ligament 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 visualized throughout a 90°
range of motion. Findings were documented on digital photographs and on video. Results were compared against the MRI appearance of the injured menisco-fibular ligament in twenty patients. Concomitant knee injuries in those patients were also analyzed to determine the most frequent pattern of injuries.
Results
The normal menisco-fibular ligament 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 visualization of the ligament was possible even in regular sequences, however also additional radial plane sequencs were used. Arthroscopic visualization and manipulation was optimal when the camera was inserted into the postero-lateral gutter with full knee extension.
Conclusions
The menisco-fibular ligament stabilizes the postero-lateral knee in concert with the menisco-femoral ligaments. Injury to the menisco-fibular ligament 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.