MRI evaluation of the peripheral attachments of the lateral meniscal body: the menisco-tibio-popliteus-fibular complex

Knee Surg Sports Traumatol Arthrosc. 2022 Apr;30(4):1461-1470. doi: 10.1007/s00167-021-06633-5. Epub 2021 Jun 17.

Abstract

Purpose: To determine, identify and measure the structures of the menisco-tibio-popliteus-fibular complex (MTPFC) with magnetic resonance imaging (MRI) in knees without structural abnormalities or a history of knee surgery.

Methods: One-hundred-and-five knees without prior injury or antecedent surgery were analyzed by means of MRI. The average age was 50.1 years ± 14.8. All the measurements were performed by three observers. The peripherical structures of the lateral meniscus body were identified to determine the location, size, and thickness of the entire MTPFC. The distance to other "key areas" in the lateral compartment was also studied and compared by gender and age.

Results: The lateral meniscotibial ligament (LMTL) was found in 97.1% of the MRIs, the popliteofibular ligament (PFL) in 93.3%, the popliteomeniscal ligaments (PML) in 90.4% and the meniscofibular ligament (MFL) in 39%. The anteroposterior distance of the LMTL in an axial view was 20.7 mm ± 3.9, the anterior thickness of the LMTL was 1.1 mm ± 0.3, and the posterior thickness of the LMTL 1.2 mm ± 0.1 and the height in a coronal view was 10.8 mm ± 1.9. The length of the PFL in a coronal view was 8.7 mm ± 2.5, the thickness was 1.4 mm ± 0.4 and the width in an axial view was 7.8 mm ± 2.2.

Conclusions: The MTPFC has a constant morphological and anatomical pattern for three of its main ligaments and can be easily identified and measured in an MRI; the MFL has a lower prevalence, considering a structure difficult to identify by 1.5 T MRI.

Keywords: Lateral menisco-tibial ligament; Lateral meniscus; Menisco-tibio-popliteus-fibular complex; Meniscofibular ligament; Popliteo-fibular ligament; Popliteo-meniscal ligaments.

MeSH terms

  • Fibula / anatomy & histology
  • Humans
  • Knee Joint* / anatomy & histology
  • Knee Joint* / diagnostic imaging
  • Ligaments, Articular / anatomy & histology
  • Ligaments, Articular / diagnostic imaging
  • Magnetic Resonance Imaging
  • Menisci, Tibial* / anatomy & histology
  • Menisci, Tibial* / diagnostic imaging
  • Middle Aged