Which meniscus is attached

Knee menisci. Reference article, Radiopaedia. URL of Article. On this page:. Quiz questions. Niitsu M. Magnetic Resonance Imaging of the Knee. Springer Berlin Heidelberg. Read it at Google Books - Find it at Amazon 2. The meniscal roots: gross anatomic correlation with 3-T MRI findings. MR imaging of the knee: expanded classification and pitfalls to interpretation of meniscal tears. Ali S et al. Normal variants of the meniscus. Applied Radiology.

May PDF 5. De Smet AA. How I diagnose meniscal tears on knee MRI. Turek's orthopaedics. Read it at Google Books - Find it at Amazon 7. These crescent-shaped shock absorbers between the tibia and femur have an important role in the function and health of the knee.

Once thought to be of little use, the menisci plural were routinely removed when torn. Now we know that the menisci contribute to a healthy knee because they play important roles in joint stability, force transmission, and lubrication. When possible, they are repaired if injured. There are even experimental attempts to replace a damaged meniscus, possibly an important advance in orthopaedic medicine. There are two categories of meniscal injuries - acute tears and degenerative tears.

The two menisci of the knee are crescent-shaped wedges that fill the gap between the tibia and femur. The menisci provide joint stability by creating a cup for the femur to sit in. The outer edges are fairly thick while the inner surfaces are thin. If the menisci were missing, the curved femur would move on the flat tibia. The medial meniscus , located on the inside of the knee, is more of an elongated "C"- shape, as the tibial surface is larger on that side.

The medial meniscus is more commonly injured because it is firmly attached to the medial collateral ligament and joint capsule. The lateral meniscus, on the outside of the knee, is more circular in shape. The lateral meniscus is more mobile than the medial meniscus as there is no attachment to the lateral collateral ligament or joint capsule. The outer edges of each meniscus attach to the tibia by the short coronary ligaments.

Other short ligaments attach the ends of the menisci to the tibial surface. The inner edges are free to move because they are not attached to the bone. This lets the menisci change shape as the joint moves. The front portion of the meniscus is referred to as the anterior horn , the back portion is the posterior horn , and the middle section is the body. Under the microscope, the meniscus is fibrocartilage that has strength and flexibility from collagen fiber.

Its resilience is due to the high water content in the spaces between the cells. There is not much blood supply to the menisci. Blood flows only to the outer edges from small arteries around the joint. The poor blood supply to the inner portion of the meniscus makes it difficult for the meniscus to heal. The meniscus acts as a shock absorber for the knee by spreading compression forces from the femur over a wider area on the tibia. The important role of the meniscus in force transmission can be seen when the menisci are removed.

If the menisci are removed, the forces are no longer distributed over a wide area of the tibia. This means the same forces from the femur are concentrated on a smaller area of the tibia. This can lead to degenerative arthritis.

In the s and s, it was common to remove a damaged meniscus entirely. This frequently led to early degenerative arthritis in many patients. Removing the entire medial meniscus can lead to a bow-legged deformity and medial joint arthritis. Removing the entire lateral meniscus can cause a knock-kneed deformity and lateral joint arthritis. Patients describe meniscal tears in a variety of ways. Knowing where and how a meniscus was torn helps the doctor determine the best treatment.

What are the signs and symptoms of a meniscus injury? Acute tears are often sports related and usually the result of a twisting injury in the younger, active adult population.

Symptoms of an acute tear are usually pain, swelling, and movement irregularities. When the tear gets in the way of normal knee motion, the knee can "catch" or "lock" as it moves. Degenerative tears are more common in the older population.

The patient may experience repeated swelling, but often can't recall any specific injury. The swelling also may be the result of an injury caused by a very minor movement. Mechanical symptoms, such as the knee catching or locking, often exist. Or, the patient may simply experience pain.

How is a meniscus injury diagnosed? The orthopaedic surgeon will first take a history of the injury to help determine if the signs and symptoms might suggest meniscal damage.

Next the doctor will evaluate the knee for swelling and tenderness in a physical examination. The knee will be tender when pressed on the injured side where the tibia and femur meet.

The McMurray's maneuver is a test in which the doctor applies pressure and moves the knee from straight to bent to straight again to see what positions cause pain or catching indications of a meniscal tear.

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