Abstract:Although meniscofemoral ligaments are distinct anatomic units, their anatomy and function are controversial from an anatomic and radiologic point of view. Five hundred knee MR examinations were retrospectively studied in an effort to demonstrate the incidence and variations regarding sex and age distribution, as well as the anatomy of the meniscofemoral ligament at magnetic resonance imaging. Patients were mostly men, three hundred and twelve, in contrast with women who were fewer, one hundred eighty-eight pat… Show more
“…There is no literature about the age correlation with MFL CSA, but several authors have noted a possible degeneration of the MFLs with age [ 7 , 8 ] or have reported diminishing tensile strength in elderly populations [ 6 ], which may be explained by a thinning of the ligaments.…”
Section: Discussionmentioning
confidence: 99%
“…One explanation for this documented variability may be found in the work of Woo et al [ 6 ], who showed that the ligaments in the knee joint were significantly stronger in young adults than in the elderly. Age-related degeneration of the MFLs would involve not only a weakening of the MFL structure, but also the possible eventual disappearance of the MFLs, as studies have also suggested [ 7 , 8 ]. Fig.…”
ObjectivesTo quantify the morphological correlation between the posterior cruciate ligament (PCL) and the meniscofemoral ligaments (MFLs), to propose normal ranges for different age populations, and to define guidelines for correct identification and differentiation of MFLs in routine MRI.MethodsThree hundred forty-two subjects were included retrospectively and subdivided into five age groups. Morphometrics of the PCL and the MFLs were measured on standard MRI in the sagittal, coronal, and axial planes. Student’s t test, Mann-Whitney U test, and ANOVA and Kruskal-Wallis tests with Bonferroni correction were used for comparison.ResultsThe MFLs did not vary significantly between sexes (p > 0.05) or in those older than 10 years (p > 0.05). Longitudinal MFL growth is completed before age 11 years, with cross-sectional area (CSA) increasing until age 20. The CSA of the PCL was significantly (p = 0.028) larger in knees without a pMFL (Mdn = 39.7 mm2) than with a pMFL (Mdn = 35.4 mm2). MFLs were more often detected on sagittal than coronal images.ConclusionsThis study describes the morphometric relation between the PCL and the MFLs on routine MRI. When reporting imaging findings in preparation for arthroscopic knee surgery, evaluation of MFLs, first in the sagittal and then the coronal plane, will achieve the best results.Key Points
• The MFLs and the PCL have distinct morphological patterns throughout life.
• These patterns show intimate anatomical relationships and a potential biomechanical impact.
• Those patterns and relationships can be quantified with MRI.
• A correlation exists between age and morphometrics of the MFLs.
• Recommendations for correct identification of the MFLs are provided.
“…There is no literature about the age correlation with MFL CSA, but several authors have noted a possible degeneration of the MFLs with age [ 7 , 8 ] or have reported diminishing tensile strength in elderly populations [ 6 ], which may be explained by a thinning of the ligaments.…”
Section: Discussionmentioning
confidence: 99%
“…One explanation for this documented variability may be found in the work of Woo et al [ 6 ], who showed that the ligaments in the knee joint were significantly stronger in young adults than in the elderly. Age-related degeneration of the MFLs would involve not only a weakening of the MFL structure, but also the possible eventual disappearance of the MFLs, as studies have also suggested [ 7 , 8 ]. Fig.…”
ObjectivesTo quantify the morphological correlation between the posterior cruciate ligament (PCL) and the meniscofemoral ligaments (MFLs), to propose normal ranges for different age populations, and to define guidelines for correct identification and differentiation of MFLs in routine MRI.MethodsThree hundred forty-two subjects were included retrospectively and subdivided into five age groups. Morphometrics of the PCL and the MFLs were measured on standard MRI in the sagittal, coronal, and axial planes. Student’s t test, Mann-Whitney U test, and ANOVA and Kruskal-Wallis tests with Bonferroni correction were used for comparison.ResultsThe MFLs did not vary significantly between sexes (p > 0.05) or in those older than 10 years (p > 0.05). Longitudinal MFL growth is completed before age 11 years, with cross-sectional area (CSA) increasing until age 20. The CSA of the PCL was significantly (p = 0.028) larger in knees without a pMFL (Mdn = 39.7 mm2) than with a pMFL (Mdn = 35.4 mm2). MFLs were more often detected on sagittal than coronal images.ConclusionsThis study describes the morphometric relation between the PCL and the MFLs on routine MRI. When reporting imaging findings in preparation for arthroscopic knee surgery, evaluation of MFLs, first in the sagittal and then the coronal plane, will achieve the best results.Key Points
• The MFLs and the PCL have distinct morphological patterns throughout life.
• These patterns show intimate anatomical relationships and a potential biomechanical impact.
• Those patterns and relationships can be quantified with MRI.
• A correlation exists between age and morphometrics of the MFLs.
• Recommendations for correct identification of the MFLs are provided.
“…According to Watanabe et al 2) , 32.5% of the meniscofemoral ligaments were present with Wrisberg ligament and 33% were present with Humphrey ligament and seen either as a discrete low signal-intensity bulge or a lump along the concave surface of the PCL or as a small, ovoid, low signal intensity focus just anterior to the PCL. In a study performed by Bintoudi et al 3) , only 81 among 500 patients (37%) presented both meniscofemoral ligaments and in other studies of Moran et al 4) and Lee et al 5) , the percentage was 28% and 1%, respectively. Erbagci et al 6) did not reveal the incidence.…”
A 58-year-old male patient who had developed left knee pain with a history of trauma was referred to our hospital. Physical examination and further examination by magnetic resonance imaging revealed results that closely resemble a horizontal tear of the lateral meniscus and a tear of the medial meniscus. Arthroscopically, we found a cord-like structure originating from the posterior 1/3 portion of the lateral meniscus and passing obliquely toward the medial femoral condyle in front of the posterior cruciate ligament without a tear of the lateral meniscus. In this report, we describe a rare case of anterior meniscofemoral ligament that was clearly seen on arthroscopy and mimicked a meniscal tear, which is also known as a pseudo-tear of the meniscus.
“…The high-risk sources of bias primarily pertained to 1 domain (methodology characterization), which has previously been identified as a source of variability. 11 , 32 …”
Background: The posterior meniscofemoral ligament (pMFL) of Wrisberg attaches to the posterior horn of the lateral meniscus and the lateral intercondylar aspect of the medial femoral condyle and passes posteriorly to the posterior cruciate ligament (PCL). The pMFL plays a role in recovery after PCL injuries and offers stability to the lateral meniscus, promoting normal knee function. Purpose/Hypothesis: The aim of the magnetic resonance imaging (MRI) arm of this study was to evaluate the prevalence of the pMFL in Polish patients. The purpose of the systematic review and meta-analysis was to evaluate the clinical relevance of the pMFL in knee surgery. It was hypothesized that extensive variability exists in reports on the prevalence, function, and clinical significance of the pMFL. Study Design: Cross-sectional study and systematic review; Level of evidence, 3. Methods: A retrospective MRI investigation was conducted on 100 randomly selected lower limbs of Polish patients (56 male, 44 female) performed in 2019 to determine the prevalence of the pMFL. Additionally, an extensive literature search of major online databases was performed to evaluate all reported data on the pMFL. Assessments of article eligibility and data extraction were completed independently by 2 reviewers, and all disagreements were resolved via a consensus. A quality assessment of the included articles was performed using the Anatomical Quality Assessment tool. Results: In the MRI arm of this study, the pMFL was observed in 73 of the 100 limbs. In the meta-analysis, 47 studies were included, totaling 4940 lower limbs. The pooled prevalence of the pMFL was found to be 70.4% (95% CI, 63.4%-76.9%); the mean length was 27.7 mm (95% CI, 24.8-30.5 mm) and the mean widths were 4.5, 6.1, and 4.1 mm for the meniscal and femoral attachments and midportion, respectively. The mean pMFL thickness was 2.3 mm (95% CI, 1.8-2.7 mm). Conclusion: Despite the variability in the literature, the pMFL was found to be a prevalent and large anatomic structure in the knee joint. The shared features of this ligament with the PCL necessitate the consideration of its value in planning and performing arthroscopic procedures of the knee.
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