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The Meniscal Roots: Gross Anatomic Correlation with 3-T MRI Findings

¹ Department of Diagnostic Imaging, Brown Medical School, Rhode Island Hospital, 593 Eddy St., Providence, RI 02903.
² Department of Orthopaedic Surgery, Brown Medical School, Rhode Island Hospital, Providence, RI.
³ Bioengineering Laboratory, Brown Medical School, Providence, RI.

View larger version (57K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —Cadaver of 59-year-old man. Long black arrow indicates anterior root of medial meniscus (MM); short black arrow, posterior root of medial meniscus; long white arrow, anterior root of lateral meniscus (LM); short white arrow, posterior root of lateral meniscus. Superior-view drawing shows relative insertion site positions on right tibial articular surface.

View larger version (66K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —Cadaver of 59-year-old man. Long black arrow indicates anterior root of medial meniscus (MM); short black arrow, posterior root of medial meniscus; long white arrow, anterior root of lateral meniscus (LM); short white arrow, posterior root of lateral meniscus. Superior-view drawing shows relations to anterior cruciate ligament (asterisk), posterior cruciate ligament (P), posterior meniscofemoral Wrisberg's ligament (black arrowhead), and transverse genual ligament (white arrowhead).

View larger version (46K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1C —Cadaver of 59-year-old man. Long black arrow indicates anterior root of medial meniscus (MM); short black arrow, posterior root of medial meniscus; long white arrow, anterior root of lateral meniscus (LM); short white arrow, posterior root of lateral meniscus. Superior-view drawing shows relative locations of tibial insertion sites with soft-tissue structures removed. Asterisk indicates anterior cruciate ligament. P = posterior cruciate ligament.

View larger version (117K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1D —Cadaver of 59-year-old man. Long black arrow indicates anterior root of medial meniscus (MM); short black arrow, posterior root of medial meniscus; long white arrow, anterior root of lateral meniscus (LM); short white arrow, posterior root of lateral meniscus. Photograph corresponds to C. MP = medial tibial plateau, MT = medial tibial tubercle, LT = lateral tibial tubercle, LP = lateral tibial plateau. P = Posterior cruciate ligament.

View larger version (120K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —Cadaver of 59-year-old man. Photographs show anatomic relations of anterior meniscal roots, transverse genual ligament, and tibial insertion of anterior cruciate ligament (ACL). Anterior view of knee with menisci and ligaments removed shows outlined insertional footplate of anterior root of medial meniscus (black arrow) on anterior intercondylar crest (arrowheads), anterior root of lateral meniscus (white arrow), and tibial insertion site of ACL (asterisk). LP = lateral tibial plateau, LT = lateral tibial tubercle, MP = medial tibial plateau, MT = medial tibial tubercle.

View larger version (117K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —Cadaver of 59-year-old man. Photographs show anatomic relations of anterior meniscal roots, transverse genual ligament, and tibial insertion of anterior cruciate ligament (ACL). Anterior view of knee with meniscus and ligaments in place shows relations of anterior root of medial meniscus (black arrow), anterior root of lateral meniscus (white arrow), ACL (asterisk), and transverse genual ligament (hook).

View larger version (118K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —Cadaver of 59-year-old man. Photographs show anatomic relations of anterior meniscal roots, transverse genual ligament, and tibial insertion of anterior cruciate ligament (ACL). Anterior view of knee with ACL removed (asterisk) shows shared insertion of anterior root of lateral meniscus (white arrow) and fibers of anterior root of medial meniscus (black arrow) in foreground.

View larger version (122K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —Cadaver of 51-year-old woman. Intermediate-weighted, fat-saturated, turbo spin-echo (TR/TEeff, 3,700/29) 3-T MR images of knee show anatomic relations of anterior meniscal roots, anterior cruciate ligament (ACL), and transverse genual ligament. Coronal MR image through anterior tibial plateau shows separation of anterior root of medial meniscus (arrow) and transverse genual ligament (arrowhead). MM = medial meniscus.

View larger version (124K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —Cadaver of 51-year-old woman. Intermediate-weighted, fat-saturated, turbo spin-echo (TR/TEeff, 3,700/29) 3-T MR images of knee show anatomic relations of anterior meniscal roots, anterior cruciate ligament (ACL), and transverse genual ligament. Coronal MR image posterior in relation to A shows proximity of insertion (circle) of anterior root of lateral meniscus (LM) on lateral slope of medial tibial tubercle (MT) to tibial insertion site of ACL (asterisk). P = posterior cruciate ligament, MM = medial meniscus.

View larger version (140K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —Cadaver of 51-year-old woman. Intermediate-weighted, fat-saturated, turbo spin-echo (TR/TEeff, 3,700/29) 3-T MR images of knee show anatomic relations of anterior meniscal roots, anterior cruciate ligament (ACL), and transverse genual ligament. Contiguous midline MR image shows insertion of anterior root of medial meniscus (arrow) on intercondylar crest anterior in relation to transverse genual ligament (white arrowhead) and ACL (asterisk). Black arrowhead indicates Wrisberg's ligament. P = posterior cruciate ligament.

View larger version (141K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3D —Cadaver of 51-year-old woman. Intermediate-weighted, fat-saturated, turbo spin-echo (TR/TEeff, 3,700/29) 3-T MR images of knee show anatomic relations of anterior meniscal roots, anterior cruciate ligament (ACL), and transverse genual ligament. Parasagittal MR image lateral to B shows insertion of anterior root of lateral meniscus (arrow) intermingling with ACL (asterisk) posterior in relation to transverse genual ligament (white arrowhead). Black arrowhead indicates Wrisberg's ligament.

View larger version (114K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4A —Cadaver of 59-year-old man. Photographs show anatomic relations of posterior meniscal roots and tibial insertion of anterior and posterior cruciate ligaments. Posterior view of tibial plateau with menisci and ligaments removed shows outlined insertion sites of posterior root of lateral meniscus (white arrow), posterior root of medial meniscus (black arrow), and posterior cruciate ligament (P). MP = medial tibial plateau, MT = medial tibial tubercle, LT = lateral tibial tubercle, LP = lateral tibial plateau.

View larger version (118K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4B —Cadaver of 59-year-old man. Photographs show anatomic relations of posterior meniscal roots and tibial insertion of anterior and posterior cruciate ligaments. Posterior view of knee shows insertion of posterior root of lateral meniscus (LM) (white arrow) is farther anterior than those of posterior root of medial meniscus (MM) (black arrow) and posterior cruciate ligament (P). Insertion of anterior cruciate ligament (asterisk) is anterior to intertubercular ridge but appears closer to posterior root of lateral meniscus owing to photographic distortion.

View larger version (128K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 4C —Cadaver of 59-year-old man. Photographs show anatomic relations of posterior meniscal roots and tibial insertion of anterior and posterior cruciate ligaments. Posterior view of knee with cruciate ligaments removed corresponds to B. Long white arrow indicates anterior root of lateral meniscus (LM). Short white arrow = posterior root of lateral meniscus, black arrow = posterior root of medial meniscus (MM), MT = medial tibial tubercle, LT = lateral tibial tubercle, P = posterior cruciate ligament.

View larger version (125K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5A —Cadaver of 59-year-old man. Intermediate-weighted, fat-saturated, turbo spin-echo (TR/TEeff, 3,700/29) 3-T MR images show anatomic relations of posterior meniscal roots and cruciate ligaments. Coronal MR image shows posterior root of medial meniscus (MM) (arrow) covering more than one section thickness on posterior intercondylar area. LM = lateral meniscus. LT = lateral tibial tubercle.

View larger version (123K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5B —Cadaver of 59-year-old man. Intermediate-weighted, fat-saturated, turbo spin-echo (TR/TEeff, 3,700/29) 3-T MR images show anatomic relations of posterior meniscal roots and cruciate ligaments. Coronal images sequentially more ventral to A show insertions of posterior root of lateral meniscus (LM) (white arrow) and posterior root of medial meniscus (MM) (black arrow, B) covering more than one section thickness on posterior intercondylar area. MT = medial tibial tubercle.

View larger version (117K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5C —Cadaver of 59-year-old man. Intermediate-weighted, fat-saturated, turbo spin-echo (TR/TEeff, 3,700/29) 3-T MR images show anatomic relations of posterior meniscal roots and cruciate ligaments. Coronal images sequentially more ventral to A show insertions of posterior root of lateral meniscus (LM) (white arrow) and posterior root of medial meniscus (MM) (black arrow, B) covering more than one section thickness on posterior intercondylar area. MT = medial tibial tubercle.

View larger version (132K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5D —Cadaver of 59-year-old man. Intermediate-weighted, fat-saturated, turbo spin-echo (TR/TEeff, 3,700/29) 3-T MR images show anatomic relations of posterior meniscal roots and cruciate ligaments. Sagittal image through posterior cruciate ligament (P) shows insertion site of posterior root of medial meniscus (arrow) just anterior in relation to insertion site of ligament. MT = medial tibial tubercle. Arrowhead indicates anterior genual ligament.

View larger version (124K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 5E —Cadaver of 59-year-old man. Intermediate-weighted, fat-saturated, turbo spin-echo (TR/TEeff, 3,700/29) 3-T MR images show anatomic relations of posterior meniscal roots and cruciate ligaments. Sagittal MR image through anterior cruciate ligament (asterisk) shows insertion site of posterior root of lateral meniscus (arrow) slightly anterior in relation to insertion site of medial meniscus. Circle indicates shared insertion site of anterior cruciate ligament and anterior root of lateral meniscus. Arrowhead indicates anterior genual ligament. P = posterior cruciate ligament.

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