https://www.physio-pedia.com/index.php?title=Lateral_meniscus&oldid=221056. 2 Comments ... Posterior Horn Tear of Lateral Meniscus, Innovative Repair Technique Feat. The collateral ligaments both originate proximally on the respective epicondyles of the femur. During the first year of life the meniscus contains blood vessels throughout its body but when the weight bearing starts the vascularity and the circulatory network diminish and only 25-33% area remain vascular by the capillaries of the capsule and synovial membrane[1]. The authors considered this lesion an anomaly, not a true discoid meniscus, but were unable to document the presence or absence of a meniscofemoral ligament. small ligaments/retinaculia from LM to the capsule: inferior meniscopopliteal ligament at the body: the floor of popliteal hiatus, superior and inferior meniscopopliteal ligaments at body-posterior horn junction, superior meniscopopliteal ligament at posterior horn: the roof of popliteal hiatus, supply from the peripheral meniscal plexus, in turn formed from the medial, lateral and middle genicular arteries, red-white zone: transition between outer third and inner two-thirds, reflecting the reality that the loss of perfusion is gradual and also variable from site to site, patient to patient, posterior articular branch of the tibial nerve and terminal obturator and femoral nerve branches, anterior root onto the ACL or intercondylar notch, anterior margin of the tibia in the midline, no attachment: stabilized by the transverse meniscal ligament. The lateral meniscus is almost circular and covers a larger portion of the tibial articular surface than the Illustration of an anatomic two-tunnel transtibial medial meniscus posterior root repair. J Athl Train. Radiographics. The anterior horn of the lateral meniscus blends into the attachment of the anterior cruciate ligament, whereas the posterior horn attaches just behind the intercondylar eminence, often blending into the posterior aspect of the ACL. The medial meniscus has a third point of attachment at the Medial Collateral Ligament (MCL) which is found on the medial (inner) side of the knee. Lateral Menisco-Capsular Re-Attachment. Type 3: The Wrisberg variant, where the meniscus may have a normal morphology but lacks its posterior attachments; ie, the meniscotibial ligament and meniscal fascicles. Brunker,Khan.Clinical Sports Medicine.3rd Edition. It may have a relatively steep concavity in the posterior horn, simulating a bucket handle tear. Read more, © Physiopedia 2021 | Physiopedia is a registered charity in the UK, no. Turek's orthopaedics. Its peripheral attachment is interrupted posterior to where the popliteal tendon passes. Three types of DLM 1. 1173185. 4. The medial posterior meniscotibial ligament is located medially and posteriorly to the medial meniscal root There is no attachment of the lateral meniscus to the LCL. Fibrous connections extending from the ante-rior horn of the lateral meniscus attachment to the ACL bundles are constant (the anterior aspect of the anterior horn of the lateral meniscus attach-ment is aligned with the AM bundle, whereas the posterior aspect fibrous attachments are aligned Ali S et al. These crescent-shaped shock absorbers between the tibia and femur have an important role in the function and health of the knee. 17.3 and 17.4). The patient comes up with major complain of knee pain, swelling and knee locking which is when the patient is unable to straighten the leg fully. Once thought to be of little use, the menisci (plural) were routinely removed when torn. Mesgarzadeh M, Moyer R, Leder DS et-al. Type … In most injuries, it is the posterior root attachment that is torn. The posterior part of the lateral meniscus is attached relatively firmly; these attachments are augmented by anterior (Humphrey) and posterior (Wrisberg) meniscofemoral ligaments, running anterior and posterior to the posterior cruciate ligament, respectively. Menisci rests between the thigh bone femur and the tibia and there are two knee joint ligaments. This can be accompanied by a clicking feeling. When refering to evidence in academic writing, you should always try to reference the primary (original) source. The vascularity diminishes so much that in 4th decade of life only the periphery is vascular whereas the center of the menisci is avascular. Wrisberg ligament type- the lateral meniscus has no attachment to the tibial plateau posteriorly but has a menisco femoral ligament or ligament of Wrisberg ISBN:0781742986. Peterson,Renström. Normal MR imaging anatomy of the knee. 6. That is usually the journal article where the information was first stated. During their review they reported finding a study observing 17.5% of knees having a strong popliteus muscle to lateral meniscus attachment, and 37.5% having a flimsy attachment. The lateral meniscus is almost circular and covers a larger portion of the tibial articular surface than the medial meniscus. The meniscal roots: gross anatomic correlation with 3-T MRI findings. In a previous post reviewed the popliteus muscle and it’s relationship to the lateral meniscus. The tibial attachments of both anterior roots were defined and quantified by categorizing the fibers of the root as either central, dense attachments or peripheral, supplemental attachments. If you believe that this Physiopedia article is the primary source for the information you are refering to, you can use the button below to access a related citation statement. Disruption of the meniscal root attachments leads to altered biomechanics, resulting in progressive cartilage loss, osteoarthritis, and subchondral edema, with the … 9. The diagnosis of a lateral meniscus injury is considered to be fairly certain if three or more of the following findings are present:[5]– tenderness at one point over the lateral joint line;– pain in the area of the lateral joint line during hyperextension of the knee joint;– pain in the area of the lateral joint line during hyperflexion of the knee joint;– pain during internal rotation of the foot and the lower leg when the knee is flexed at different angles;– weakened or hypotrophied quadriceps muscle. The firm attachment of the arcuate ligament to the lateral meniscus and the attachment of the popliteus muscle to both the arcuate ligament and meniscus ensure the dynamic retraction of the posterior segment of the meniscus during internal rotation of the tibia on the femur as the knee begins to flex from its fully extended position. posterior meniscofemoral ligament of Wrisberg, anterior meniscofemoral ligament of Humphrey, anomalous insertion of the medial meniscus, speckled anterior horn of lateral meniscus, posterior suprapatellar (prefemoral or supratrochlear) fat pad, anterior suprapatellar (quadriceps) fat pad, accessory anterior inferior tibiofibular ligament, superficial posterior tibiotalar ligament, superficial posterior compartment of the leg (calf), descending branch of the lateral circumflex, C-shape - open and wide, almost semi-circular, posterior horn substantially larger than anterior horn, C-shape - tight and closed off more like an incomplete circle, i.e. This mobility is explained by the close proximity of the attachments of the anterior and posterior horns and the lack of attachment to the capsular ligament posterolaterally. May 2013:14-18. 1993;13 (3): 489-500. Each meniscus is C-shaped in the transverse plane and consists of the following connected parts: In cross-section, they have a triangular shape, being thicker peripherally and thinning to a free-edge centrally. 2011;19 (3): 637-53, ix-x. In most cases Physiopedia articles are a secondary source and so should not be used as references. A slow twisting force may also cause the tear.Damage to the meniscus is due to rotational forces directed to a flexed knee (as may occur with twisting sports) is the usual underlying mechanism of injury[5][6]. Zimny ML, Albright DJ, Dabezies E: Mechanoreceptors in the human medial meniscus. Although there are several tests for a meniscus tear, none can be considered definitive without considerable experience on the part of the examiner. Type 2: An incomplete slab of meniscal tissue with 80% coverage of the lateral tibial plateau. The anterior root of the lateral meniscus (LM) dives underneath the tibial attachment of the anterior cruciate ligament (ACL). Posterior horn tears are much more common and located in the back of the meniscus. Vascular Anatomy Although the distinct role of meniscal attachments has been investigated, the relationship between the LM anterior insertion (LMAI) and ACL tibial insertion (ACLTI) remains unclear. DISCOID LATERAL MENISCUS Defnition Discoid lateral meniscus (DLM) is an anatomic variation of the lateral meniscus that may be asymptomatic or can cause snapping or popping of the knee. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. Normal variants of the meniscus. In addition to describing the type of tear, most MRI and surgical reports will describe the location of the tear. anterior and posterior tibial roots are very close to each other, superior articular surface - also known as femoral surface, inferior articular surface - also known as tibial surface, the anterior horn of the medial meniscus attaches immediately anterior to the tibial attachment of the, medial aspect attached to the deep (third) layer of the, posterior horn is attached to the posterior, the anterior horn of the lateral meniscus attaches immediately lateral to the tibial attachment of the ACL on the, attached to joint capsule except anterior horn and posterior most portion of posterior horn; this is due to the passage of the intra-articular portion of the, posterior horn of the lateral meniscus attaches to the posterior, joint capsule peripherally except the lateral meniscus at the site of the. Abstract. 7. Their shape is maintained by the collagen within them. Arch Orthop Trauma Surg 120:201–204, 2000. Clinical Practice Guideline: Meniscal and Articular Cartilage Lesions, Sign up to receive the latest Physiopedia news, The content on or accessible through Physiopedia is for informational purposes only. The lateral collateral ligament lies over the popliteal tendon and inserts distally on the head of the fibula. One meniscus is on the inner side of your knee--the medial meniscus. The lateral meniscus is more mobile than themedial meniscus, and has a range of movement that may be as great as 10 mm (0.4 in) in an anteroposterior direction. By Boris Poberaj 4 Videos. 2. I give my consent to Physiopedia to be in touch with me via email using the information I have provided in this form for the purpose of news, updates and marketing. OBJECTIVE. The anchoring of the medial meniscus is consistent, whereas the attachment of the lateral meniscus is variable. The menisci are vascularized only via the periphery and the root attachments and therefore the inner portions are avascular. The lateral meniscus is consistent in width throughout its course. ADVERTISEMENT: Supporters see fewer/no ads, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Clin Orthop 402:122–134, 2002. Springer Berlin Heidelberg. AJR Am J Roentgenol. 5. Acta Anat (Basel) 133:35–40, 1988. The menisci are C-shaped fibrocartilage structures vital for shock absorption and stability at the knee. The most common mechanism of menisci injury is a twisting injury with the foot anchor on the ground, often by another player's body. In addition, the medial meniscus is adherent to the deep portion of the medial collateral ligament and may attach to the lateral meniscus via the transverse intermeniscal ligament. The lateral meniscus is attached to the shin and is located on the outer side of the knee. to the semi-circular cartilage on the outside of the knee joint. The menisci play an important biomechanical role in axial load distribution of the knees by means of hoop strength, which is contingent on intact circumferentially oriented collagen fibers and meniscal root attachments. Applied Radiology. Vohra S, Arnold G, Doshi S et-al. Brody JM, Hulstyn MJ, Fleming BC et-al. The medial meniscus is on the inner side of the knee joint. The medial meniscus and lateral meniscus are specialized structures within the knee. 12 Anterior horn tears are less common and located in the front of the meniscus. The meniscus attaches to the tibia via coronary ligaments. They act as shock absorbers and stabilize the knee. Check for errors and try again. {"url":"/signup-modal-props.json?lang=us\u0026email="}, {"containerId":"expandableQuestionsContainer","displayRelatedArticles":true,"displayNextQuestion":true,"displaySkipQuestion":true,"articleId":26810,"mcqUrl":"https://radiopaedia.org/articles/knee-menisci/questions/1834?lang=us"}. The lateral meniscus has no additional attachments to the corresponding collateral ligaments and only loose peripheral attachments to the joint capsule, which is interrupted by the popliteal tendon at the popliteal hiatus. The menisci — the medial meniscus and lateral meniscus - are crescent-shaped bands of thick, rubbery cartilage attached to the shinbone (tibia). Background:The posterior meniscofemoral ligament (pMFL) of Wrisberg attaches to the posterior horn of the lateral meniscus and the lateral intercondylar aspect of … J Orthop Sports Phys Ther 29:23–30, 1999. Patient history and the mechanism of injury also provide a major source of information. AJR Am J Roentgenol. When working together, the medial and lateral meniscus together transmit as much as 85% of the load when in 90 degrees of knee flexion. Nguyen JC, De Smet AA, Graf BK et-al. : Innervation of nociceptors in the menisci of the knee joint: An immunohistochemical study. They also play an important role in synovial fluid dynamic circulation and also considered by some to be involved in proprioception.
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