Meniscotibial ligaments

Changed by Joachim Feger, 15 Nov 2021

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The meniscotibial ligaments, also known as coronary ligaments, attach the knee menisci to the tibial plateau ^1-6 and have a role in rotatory knee stability and anterior tibial translation ^7-10.

Gross anatomy

The meniscotibial ligaments attach the menisci to the tibial condyles at various locations apart from the meniscal root attachments ^1-4.

Attachments

Medial meniscus

The medial meniscus is attached to the medial tibial condyle at the following locations ^1-3:

posterior horn via the posterior meniscotibial ligament ¹
midportion or corpus via the meniscotibial portion of the deep medial collateral ligament ^2,3

The meniscotibial ligaments originate immediately inferior (6-7 mm) to the edge of the articular cartilage of the medial and posterior part of the medial tibial plateau and insert at the outer surface of the medial meniscus just above the inferior edge. The medial posterior meniscotibial ligament attaches immediately inferior to the meniscocapsular ligament ^1,11.

Additional attachments are located posteromedially via the following structures ^1,12:

central meniscal attachment of the posterior oblique ligament (POL)
anterior arm of the semimembranosus tendon

Lateral meniscus

The lateral meniscus is attached to the lateral tibial condyle at the following locations ^4-6:

posterior horn via the posterior meniscotibial ligament ⁴
midportion or corpus via the lateral meniscotibial ligament, which courses obliquely immediately beneath the fibular collateral ligament ^5,6

There are additional attachments of the lateral meniscus to the popliteus muscle posterolaterally via the popliteomeniscal fascicles ⁴ and to the joint capsule at its superior border ⁴ as well as to the fibula by the meniscofibular ligament ⁵.

Relations and/or Boundaries

The medial posterior meniscotibial ligament is located medially and posteriorly to the medial meniscal root attachment ¹ and covered by the joint capsule, which forms its tibial insertion inferiorly to the origin of the meniscotibial ligament ¹. The meniscotibial attachment of the deep medial collateral ligament is covered by its superficial portion ^2,3.

The lateral posterior meniscotibial ligament is located laterally and posteriorly to the lateral meniscal root attachment and medially to the popliteal hiatus a curved gap with a lack of inferior ligamentous attachments ⁴.

Radiographic features

MRI

The coronary ligaments are visible in MRI as thin hypointense structures.

Related pathology

ramp lesion (meniscus)
- in the context of a posterior meniscotibial and/or meniscocapsular injury ¹
posteromedial corner injury of the knee
posterolateral corner injury of the knee
floating meniscus

-<p>The <strong>meniscotibial ligaments</strong>, also known as <strong>coronary ligaments</strong>, attach the <a href="/articles/knee-menisci">knee menisci</a> to the <a href="/articles/tibial-plateau">tibial plateau</a> <sup>1-6</sup> and have a role in rotatory knee stability and anterior tibial translation <sup>7-10</sup>.</p><h4>Gross anatomy</h4><p>The <strong>meniscotibial ligaments</strong> attach the menisci to the tibial condyles at various locations apart from the <a href="/articles/meniscal-root">meniscal root</a> attachments <sup>1-4</sup>. </p><h5>Attachments</h5><h6>Medial meniscus</h6><p>The <a href="/articles/knee-menisci">medial meniscus</a> is attached to the medial tibial condyle at the following locations <sup>1-3</sup>:</p><ul>
+<p>The <strong>meniscotibial ligaments</strong>, also known as <strong>coronary ligaments</strong>, attach the <a href="/articles/knee-menisci">knee menisci</a> to the <a href="/articles/tibial-plateau">tibial plateau</a> <sup>1-6</sup> and have a role in rotatory knee stability and <a title="Anterior tibial translation" href="/articles/anterior-tibial-translocation-sign">anterior tibial translation</a> <sup>7-10</sup>.</p><h4>Gross anatomy</h4><p>The <strong>meniscotibial ligaments</strong> attach the menisci to the tibial condyles at various locations apart from the <a href="/articles/meniscal-root">meniscal root</a> attachments <sup>1-4</sup>. </p><h5>Attachments</h5><h6>Medial meniscus</h6><p>The <a href="/articles/knee-menisci">medial meniscus</a> is attached to the medial tibial condyle at the following locations <sup>1-3</sup>:</p><ul>
-</ul><p>There are additional attachments of the <a href="/articles/knee-menisci">lateral meniscus</a> to the popliteus muscle posterolaterally via the popliteomeniscal fascicles <sup>4</sup> and to the joint capsule at its superior border <sup>4</sup> as well as to the fibula by the <a href="/articles/meniscofibular-ligament">meniscofibular ligament</a> <sup>5</sup>.</p><h4>Relations and/or Boundaries</h4><p>The medial posterior meniscotibial ligament is located medially and posteriorly to the medial <a href="/articles/meniscal-root">meniscal root</a> attachment <sup>1</sup> and covered by the joint capsule, which forms its tibial insertion inferiorly to the origin of the meniscotibial ligament <sup>1</sup>. The meniscotibial attachment of the deep medial collateral ligament is covered by its superficial portion <sup>2,3</sup>.</p><p>The lateral posterior meniscotibial ligament is located laterally and posteriorly to the lateral meniscal root attachment and medially to the popliteal hiatus a curved gap with a lack of inferior ligamentous attachments <sup>4</sup>.</p><h4>Radiographic features</h4><p>The coronary ligaments are visible in MRI as hypointense structures.</p><h4>Related pathology</h4><ul>
+</ul><p>There are additional attachments of the <a href="/articles/knee-menisci">lateral meniscus</a> to the popliteus muscle posterolaterally via the popliteomeniscal fascicles <sup>4</sup> and to the joint capsule at its superior border <sup>4</sup> as well as to the fibula by the <a href="/articles/meniscofibular-ligament">meniscofibular ligament</a> <sup>5</sup>.</p><h4>Relations and/or Boundaries</h4><p>The medial posterior meniscotibial ligament is located medially and posteriorly to the medial <a href="/articles/meniscal-root">meniscal root</a> attachment <sup>1</sup> and covered by the joint capsule, which forms its tibial insertion inferiorly to the origin of the meniscotibial ligament <sup>1</sup>. The meniscotibial attachment of the deep medial collateral ligament is covered by its superficial portion <sup>2,3</sup>.</p><p>The lateral posterior meniscotibial ligament is located laterally and posteriorly to the lateral meniscal root attachment and medially to the popliteal hiatus a curved gap with a lack of inferior ligamentous attachments <sup>4</sup>.</p><h4>Radiographic features</h4><h5>MRI</h5><p>The coronary ligaments are visible in MRI as thin hypointense structures.</p><h4>Related pathology</h4><ul>

References changed:

1. DePhillipo N, Moatshe G, Chahla J et al. Quantitative and Qualitative Assessment of the Posterior Medial Meniscus Anatomy: Defining Meniscal Ramp Lesions. Am J Sports Med. 2019;47(2):372-8. <a href="https://doi.org/10.1177/0363546518814258">doi:10.1177/0363546518814258</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/30525875">Pubmed</a>
2. LaPrade R, Engebretsen A, Ly T, Johansen S, Wentorf F, Engebretsen L. The Anatomy of the Medial Part of the Knee. J Bone Joint Surg Am. 2007;89(9):2000-10. <a href="https://doi.org/10.2106/JBJS.F.01176">doi:10.2106/JBJS.F.01176</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/17768198">Pubmed</a>
3. Liu F, Yue B, Gadikota H et al. Morphology of the Medial Collateral Ligament of the Knee. J Orthop Surg Res. 2010;5(1):69. <a href="https://doi.org/10.1186/1749-799X-5-69">doi:10.1186/1749-799X-5-69</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/20846377">Pubmed</a>
4. Aman Z, DePhillipo N, Storaci H et al. Quantitative and Qualitative Assessment of Posterolateral Meniscal Anatomy: Defining the Popliteal Hiatus, Popliteomeniscal Fascicles, and the Lateral Meniscotibial Ligament. Am J Sports Med. 2019;47(8):1797-803. <a href="https://doi.org/10.1177/0363546519849933">doi:10.1177/0363546519849933</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/31136201">Pubmed</a>
5. Natsis K, Paraskevas G, Anastasopoulos N, Papamitsou T, Sioga A. Meniscofibular Ligament: Morphology and Functional Significance of a Relatively Unknown Anatomical Structure. Anat Res Int. 2012;2012:214784. <a href="https://doi.org/10.1155/2012/214784">doi:10.1155/2012/214784</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/22811916">Pubmed</a>
6. Urban S, Pretterklieber B, Pretterklieber M. The Anterolateral Ligament of the Knee and the Lateral Meniscotibial Ligament - Anatomical Phantom Versus Constant Structure Within the Anterolateral Complex. Ann Anat. 2019;226:64-72. <a href="https://doi.org/10.1016/j.aanat.2019.06.005">doi:10.1016/j.aanat.2019.06.005</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/31330303">Pubmed</a>
7. Peltier A, Lording T, Maubisson L, Ballis R, Neyret P, Lustig S. The Role of the Meniscotibial Ligament in Posteromedial Rotational Knee Stability. Knee Surg Sports Traumatol Arthrosc. 2015;23(10):2967-73. <a href="https://doi.org/10.1007/s00167-015-3751-0">doi:10.1007/s00167-015-3751-0</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/26264383">Pubmed</a>
8. DePhillipo N, Moatshe G, Brady A et al. Effect of Meniscocapsular and Meniscotibial Lesions in ACL-Deficient and ACL-Reconstructed Knees: A Biomechanical Study. Am J Sports Med. 2018;46(10):2422-31. <a href="https://doi.org/10.1177/0363546518774315">doi:10.1177/0363546518774315</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/29847148">Pubmed</a>
9. Chahla J, Dean C, Moatshe G et al. Meniscal Ramp Lesions: Anatomy, Incidence, Diagnosis, and Treatment. Orthop J Sports Med. 2016;4(7):2325967116657815. <a href="https://doi.org/10.1177/2325967116657815">doi:10.1177/2325967116657815</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/27504467">Pubmed</a>
10. Raheem O, Philpott J, Ryan W, O'Brien M. Anatomical Variations in the Anatomy of the Posterolateral Corner of the Knee. Knee Surg Sports Traumatol Arthrosc. 2007;15(7):895-900. <a href="https://doi.org/10.1007/s00167-007-0301-4">doi:10.1007/s00167-007-0301-4</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/17641923">Pubmed</a>
11. Cavaignac E, Sylvie R, Teulières M et al. What Is the Relationship Between the Distal Semimembranosus Tendon and the Medial Meniscus? A Gross and Microscopic Analysis From the SANTI Study Group. Am J Sports Med. 2021;49(2):459-66. <a href="https://doi.org/10.1177/0363546520980076">doi:10.1177/0363546520980076</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/33332976">Pubmed</a>
12. Lundquist R, Matcuk G, Schein A et al. Posteromedial Corner of the Knee: The Neglected Corner. Radiographics. 2015;35(4):1123-37. <a href="https://doi.org/10.1148/rg.2015140166">doi:10.1148/rg.2015140166</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/26172356">Pubmed</a>
1. DePhillipo N, Moatshe G, Chahla J et al. Quantitative and Qualitative Assessment of the Posterior Medial Meniscus Anatomy: Defining Meniscal Ramp Lesions. Am J Sports Med. 2019;47(2):372-378. <a href="https://doi.org/10.1177/0363546518814258">doi:10.1177/0363546518814258</a>
2. LaPrade R, Engebretsen A, Ly T, Johansen S, Wentorf F, Engebretsen L. The Anatomy of the Medial Part of the Knee. J Bone Joint Surg Am. 2007;89(9):2000-10. <a href="https://doi.org/10.2106/JBJS.F.01176">doi:10.2106/JBJS.F.01176</a>
3. Liu F, Yue B, Gadikota H et al. Morphology of the Medial Collateral Ligament of the Knee. J Orthop Surg Res. 2010;5(1):69. <a href="https://doi.org/10.1186/1749-799X-5-69">doi:10.1186/1749-799X-5-69</a>
4. Aman Z, DePhillipo N, Storaci H et al. Quantitative and Qualitative Assessment of Posterolateral Meniscal Anatomy: Defining the Popliteal Hiatus, Popliteomeniscal Fascicles, and the Lateral Meniscotibial Ligament. Am J Sports Med. 2019;47(8):1797-1803. <a href="https://doi.org/10.1177/0363546519849933">doi:10.1177/0363546519849933</a>
5. Natsis K, Paraskevas G, Anastasopoulos N, Papamitsou T, Sioga A. Meniscofibular Ligament: Morphology and Functional Significance of a Relatively Unknown Anatomical Structure. Anat Res Int. 2012;2012:214784. <a href="https://doi.org/10.1155/2012/214784">doi:10.1155/2012/214784</a>
6. Urban S, Pretterklieber B, Pretterklieber M. The Anterolateral Ligament of the Knee and the Lateral Meniscotibial Ligament - Anatomical Phantom Versus Constant Structure Within the Anterolateral Complex. Ann Anat. 2019;226:64-72. <a href="https://doi.org/10.1016/j.aanat.2019.06.005">doi:10.1016/j.aanat.2019.06.005</a>
7. Peltier A, Lording T, Maubisson L, Ballis R, Neyret P, Lustig S. The Role of the Meniscotibial Ligament in Posteromedial Rotational Knee Stability. Knee Surg Sports Traumatol Arthrosc. 2015;23(10):2967-73. <a href="https://doi.org/10.1007/s00167-015-3751-0">doi:10.1007/s00167-015-3751-0</a>
8. DePhillipo N, Moatshe G, Brady A et al. Effect of Meniscocapsular and Meniscotibial Lesions in ACL-Deficient and ACL-Reconstructed Knees: A Biomechanical Study. Am J Sports Med. 2018;46(10):2422-2431. <a href="https://doi.org/10.1177/0363546518774315">doi:10.1177/0363546518774315</a>
9. Chahla J, Dean C, Moatshe G et al. Meniscal Ramp Lesions: Anatomy, Incidence, Diagnosis, and Treatment. Orthop J Sports Med. 2016;4(7):2325967116657815. <a href="https://doi.org/10.1177/2325967116657815">doi:10.1177/2325967116657815</a>
10. Raheem O, Philpott J, Ryan W, O'Brien M. Anatomical Variations in the Anatomy of the Posterolateral Corner of the Knee. Knee Surg Sports Traumatol Arthrosc. 2007;15(7):895-900. <a href="https://doi.org/10.1007/s00167-007-0301-4">doi:10.1007/s00167-007-0301-4</a>
11. Cavaignac E, Sylvie R, Teulières M et al. What Is the Relationship Between the Distal Semimembranosus Tendon and the Medial Meniscus? A Gross and Microscopic Analysis From the SANTI Study Group. Am J Sports Med. 2021;49(2):459-466. <a href="https://doi.org/10.1177/0363546520980076">doi:10.1177/0363546520980076</a>
12. Lundquist R, Matcuk G, Schein A et al. Posteromedial Corner of the Knee: The Neglected Corner. Radiographics. 2015;35(4):1123-37. <a href="https://doi.org/10.1148/rg.2015140166">doi:10.1148/rg.2015140166</a>