Research Article: Anterior and Posterior Meniscofemoral Ligaments: MRI Evaluation

Date Published: September 17, 2012

Publisher: Hindawi Publishing Corporation

Author(s): A. Bintoudi, K. Natsis, I. Tsitouridis.


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 patients. The mean age of the patients who were included in this study was 46 years. More than half of them were between 20 and 40 years old; one hundred thirty-three patients among 20 to 30 years old and one hundred and one patients among 31 and 40 years old, in total two hundred thirty-four patients.

Partial Text

An imaging breakthrough had led us to pay more attention in small anatomic structures such as the meniscofemoral ligaments. Meniscofemoral ligaments are straight bands of collagen that attach to the posterior horn of lateral meniscus and lateral part of medial femoral condyle [1]. For some authors, the meniscofemoral ligament is one ligament with two distinct bands, whereas for others are two distinct ligaments. The anterior meniscofemoral ligament (aMFL) which is leaning anterior to the posterior cruciate ligament (PCL) is also known as ligament of Humphrey, and the posterior meniscofemoral ligament (pMFL) leaning posterior to PCL is known as ligament of Wrisberg [1–6]. The incidence of the aMFL and pMFL ranges in the literature, although most of the studies are anatomic studies [2–7]. There are not many reports in the literature regarding magnetic imaging examination of the respective ligaments.The purpose of the present study is to elucidate the incidence of ligaments concerning the distribution among males and females and among patients with different ages.

Six hundred and three knee MRI examinations performed at our hospital during the period 2010-2011. Exclusion criteria include the patients with limitation on diagnosis due to motion artifacts and with imaging findings of PCL and lateral meniscus (LM) pathology. The remaining five hundred knee MRI exams were included in this retrospective study. The age of the patients ranged from 29 to 73 years (mean age 46 years). The patients were admitted for MRI exam either for chronic knee pain or after trauma.

From 603 knee MR examinations, 103 were excluded. The incidence of MFLs was evaluated in the remaining 500 knee MRIs. The pMFL or Wrisberg ligament was present in a very high percentage, 322 patients (64,4%), (Figure 1). Most of them in whom the pMFL was present were males, 240 patients (74,6%), and fewer, 82 patients (25,4%), were females. The visualization of the pMFL was easier and more frequently observed at the coronal sections (172/322/53%) rather than at the sagittal sections (150/322/47%). Although the incidence of appearance of Wrisberg ligament was high, it was usually thin and attached to PCL making the interpretation difficult.

The anatomy, the function, and the imaging of the MFLs are a major issue among anatomists, orthopedics, and radiologists. The meniscofemoral ligaments connect the posterior horn of lateral meniscus with the lateral part of medial femoral condyle [1]. There are bands of collagen that attach firmly the posterior portion of the lateral meniscus during knee flexion [5, 8]. Poirier and Charpy first described it in 1892 [3]. The name of the third cruciate ligament was mistakenly used [9]. The name of ligament is also not correctly used because meniscofemoral ligament is not extended from a bone to another bone but from a fibrocartilage anatomic structure is the meniscus to a bone [9].

The purpose of the present study was to give an overview of the radiologic prospective of the aMFL and pMFL. Degenerative cause might be able to explain the higher incidence in younger patients. The relatively large cohort of patients can contribute to the better knowledge of radiologic anatomy of meniscofemoral ligament and avert misdiagnosis of the aMFL and pMFL as loose bodies or PCL pathology.