Meniscofemoral ligaments: patterns of tears and pseudotears of the menisci using cadaveric and clinical material

Purpose The purpose of the study was to determine the different types of pseudotears of the posterior horn of the lateral meniscus caused by the nearby meniscofemoral ligaments (MFLs), and to correlate the presence of these ligaments with patterns of meniscal tear. Design Retrospective clinical study with patients and prospective observatory study with cadaveric material. Patients Magnetic resonance imaging studies of the knee in 49 patients who had subsequent arthroscopy of the knee performed over a 1-year period at a single institution were reviewed by two readers in consensus for the presence and morphology of the MFLs of Humphry (LH) and Wrisberg (LW). Ten cadaveric knee specimens were used for MRI, anatomic, and histologic study. Results The LH was present in 55% of patients, the LW in 94%, and both were present in 44.9%. The thickness of the LH and LW ranged from 1 - 3 mm ( mean 1.9, SD 0.61), and from 1 - 3.8 mm ( mean 1.8, SD 0.65) respectively ( p > 0.05). A pseudotear in the posterior horn of the lateral meniscus was present in 63% of patients. In 13% the pseudotear was vertically oriented, and in 87% the pseudotear had an anterosuperior to posteroinferior orientation, ranging from 37 to 87. There was no association between the presence of one or both MFLs and the occurrence of medial or lateral meniscal tears ( p > 0.05). Conclusion Meniscofemoral ligaments are frequent anatomical structures that are found in the majority of knees with MRI. They commonly cause a pseudotear of the posterior horn of the lateral meniscus that can be simple, double, or complex in appearance, with vertical or anterosuperior to posteroinferior orientation.