Meniscofemoral ligament

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Rear view of the left knee joint showing the meniscofemoral ligament

The meniscofemorale ligament (meniscus-femur ligament) is a ligament structure that runs from the posterior horn of the outer meniscus to the inner femoral condyle . Although ligaments from the anterior horn of the meniscus and those from the medial meniscus are also described, their frequency seems to be significantly lower.

human

Posterior meniscofemoral ligament on MRI, coronal
Posterior meniscofemoral ligament on MRI, sagittal

The most common meniscofemoral ligaments ( ligamenta meniscofemoralia ) in humans are

  • the ligamentum meniscofemorale posterius (also ligamentum Wrisberg ) behind the posterior cruciate ligament and
  • the ligamentum meniscofemorale anterius (also ligamentum Humphry ) running in front of the posterior cruciate ligament.

The Wrisberg ligament is 70% more common than the Humphry ligament is about 50% more common. The ligaments are more likely to be detectable in younger people than in older people, indicating the possibility of degeneration.

With the same origin on the medial femoral condyle, three types of Wrisberg's ligament are distinguished according to their approach:

  • Type 1: Classic approach to the posterior horn of the external meniscus
  • Type 2: Fan-like attachment from the meniscus to further medial to the shin
  • Type 3: No attachment to the meniscus, but only to the shin (other authors see it as part of the posterior cruciate ligament)

History

The first description of the meniscofemoral ligaments is attributed to Josias Weitbrecht in 1742. A detailed description of the Ligamentum Wrisberg can be found in Robert 1855. Even though Heinrich August Wrisberg has meanwhile been accepted as the eponym for the ligamentum meniscofemorale posterius, he has probably never reported on it in detail. The expression “third cruciate ligament” has been used repeatedly for the two meniscofemoral ligaments, but has not caught on in everyday life.

Function and clinical significance

Ligamentum meniscofemorale posterius (Wrisberg) behind the outer meniscus posterior horn close to its insertion. The finding can be misinterpreted as a tear in the meniscus.

The biomechanical function of the meniscofemoral ligaments is seen today primarily as limiting the posterior displacement of the tibia. The Humphry ligament tenses when the knee is flexed, the Wrisberg ligament when the knee is extended. They thus work synergistically with the posterior cruciate ligament and, if it is injured, acquire particular importance for the stability of the knee joint.

In the MRI , the course of the meniscofemoral ligament must be taken into account in order to avoid confusion with a displaced part of the external meniscus in the event of a tear.

Individual evidence

  1. ^ A. Wan et al.: The menisco-femoral ligaments. In: Clinical Anatomy. 1995, PMID 8535963 .
  2. ↑ a b c d e C. Niess, U. Stumpf, J. Petermann: Anatomy, frequency and distribution of the meniscofemoral ligaments. In: Arthroscopy. 2000. in Springer-Verlag
  3. ↑ a b c d C. Gupte et al .: Meniscofemoral ligaments revisited ANATOMICAL STUDY, AGE CORRELATION AND CLINICAL IMPLICATIONS. In: The Journal of Bone & Joint Surgery (Br). 2002.
  4. ^ A. Amis, C. Gupte, A. Bull, A. Edwards: Anatomy of the posterior cruciate ligament and the meniscofemoral ligaments. In: Knee Surgery, Sports Traumatology, Arthroscopy . 2006, PMID 16228178 .
  5. ↑ C. Gupte, A. Bull, R. Thomas, A. Amis: A review of the function and biomechanics of the meniscofemoral ligaments. In: Arthroscopy. Elsevier, 2003, PMID 12579149 .
  6. ^ A b F. Robert: Investigations into the anatomy and mechanics of the knee joint. 1855. on Google
  7. ^ E. Kaplan: The lateral meniscofemoral ligament of the knee joint. In: Bulletin of the Hospital for Joint Diseases. 1956, PMID 13413392 .
  8. ^ A. Amis et al .: Biomechanics of the PCL and related structures: posterolateral, posteromedial and meniscofemoral ligaments. (PDF file; 332 kB) In: Knee Surgery, Sports Traumatology, Arthroscopy. 2003, PMID 12961064 .
  9. ↑ P. Lertwanich et al .: Contribution of the meniscofemoral ligament as a restraint to the posterior tibial translation in a porcine knee. In: Knee Surgery, Sports Traumatology, Arthroscopy. 2010, PMID 20407757 .
  10. ↑ T. Vahey et al .: MR Imaging of the Knee: Pseudotear of the Lateral Meniscus Caused by the Meniscofemoral Ligament. In: American Journal of Roentgenology. 1990, PMID 2110735 .