The relationship between the medial collateral ligament and the medial meniscus: a topographical and biomechanical study

Abstract

The functional influence of the medial collateral ligament on the medial meniscus is still discussed controversially. Commonly, a strong fixation of the meniscus by the collateral ligament is described. Injury to the medial meniscus is explained by its reduced mobility due to its strong adherence to the medial collateral ligament. The analysis of 10 plastinated series of the medial femorotibial compartment prove that only few fibres of the ligament radiate into the meniscus. To define the possible contribution of these fibers to the stability of the medial meniscus, experiments on two fresh frozen knee joints were performed. The distal femur was separated by cutting the capsule. The medial collateral ligament was detached carefully from its femoral insertion. The tibial head with both menisci was fixed in a clamping system. A translucent, exact acrylic glass copy of the femoral component to which the medial collateral ligament was reinserted, allowed studying the behaviour of the medial meniscus under axial compression (500 N). Firstly, stress was applied while the collateral ligament was proximally fixed and under tension; then the same experiment was performed after femoral detachment of collateral ligament. All plastinated series revealed only some deep and tender fibrous bundles of the medial collateral ligament radiating into the medial meniscus proximally and posteriorly. The behaviour of medial meniscus was exactly the same in both stress experiment series. The conclusion is that there is no relevant influence of the medial collateral ligament on the stability of the medial meniscus.

Loading of the medial meniscus in the ACL deficient knee: A multibody computational study

“…In their experimental study on two cadavers, Stein et al [12] concluded that there was “no relevant influence of the medial collateral ligament on the stability of the medial meniscus”. The Stein study applied a 500 N compressive load to intact knees and after detaching the medial collateral ligament from the femur.…”

“…Anatomical studies of the dMCL have separated it into two functional units, the meniscofemoral and meniscotibial divisions, with stout attachments to the meniscus described [11]. But, in a recent study, Stein et al did not measure any differences in tibial plateau stress after transecting the dMCL meniscal attachments on two cadaver knees loaded with a 500 N axial force, concluding that the dMCL did not affect the stability of the medial meniscus [12]. …”

Predicted loading on the menisci during gait: The effect of horn laxity

“…al. concluded that the medial collateral ligament did not affect the stability of the medial meniscus (Stein, Koebke et al 2011). The anterior intermeniscal ligament (AIML) was included in our models.…”

Ultrasound‐Guided Treatment of Extrusive Medial Meniscopathy: A 3‐Step Protocol

“…Of note, the latter has some fibers mixing with the anterior cruciate ligament (ie, histologic continuum) . An anatomic detail of considerable clinical relevance would be that the medial meniscus shares fibers with the MCL near its capsular attachment . The histologic architecture of meniscal tissue consists of cells suspended in an extracellular matrix of collagen, proteoglycans, glycoproteins, and elastin .…”

“…2 An anatomic detail of considerable clinical relevance would be that the medial meniscus shares fibers with the MCL near its capsular attachment. 3 The histologic architecture of meniscal tissue consists of cells suspended in an extracellular matrix of collagen, proteoglycans, glycoproteins, and elastin. 4 A perimeniscal capillary plexus, originating in the capsular and synovial tissues of the knee joint (from the medial geniculate arteries), supplies the peripheral portion of the medial meniscus through penetrating radial vessels.…”