A Morphological and Morphometric Study on Meniscofemoral Ligaments of Knee Joint and its Variations

Introduction: There are two Meniscofemoral Ligaments (MFLs) in the knee joint, anterior Meniscofemoral Ligament (aMFL) and posterior Meniscofemoral Ligament (pMFL) named according to their position relative to Posterior Cruciate Ligament (PCL). Aim: To describe the frequency of occurrence of MFLs and their anatomical variations along with variations in their size in adult cadaveric knees. Materials and Methods: A total of 38 cadaveric knees belonging to both genders and age ranging from 40-65 years were dissected in the Department of Anatomy IPGMER, Kolkata, India over a period of two years (May 2015 to April 2017). After treating the cadavers with 10% formalin, posterior capsulotomy was done to expose the interior of the knee joint followed by anterior capsulotomy. MFLs (anterior and posterior) were identified in relation to PCL. Their frequency, size and anatomy were noted along with the variations, data analysis was done using SPSS version 23.0, compared with other studies and inference was drawn. Results: At least one MFL was present in every knee joint dissected. Both aMFL and pMFL were present in 10 (26.3%) joints, only aMFL in 4 joints (10.5%) and only pMFL in 24 joints (63.2%). An accessory band was found in 8 (21.05%) joints (2 with only aMFL and 6 with only pMFL). Mean age of subjects with both aMFL and pMFL was 45.40 +/- 3.14 years, those with either of the ligaments was 56.86 +/- 5.27 years. Mean length of aMFL and pMFL was 25.74 +/- 1.98 mm and 31.63 +/- 4.87 mm respectively. Mean length of pMFL in males and females was 33.08 +/- 3.15 mm and 28.99 +/- 6.35 mm respectively. Mean width of pMFL at lateral end was 5.97 +/- 0.96 and 5.13 +/- 1.25 in males and females respectively. Therefore, pMFL was found to be more prevalent and longer than aMFL, also pMFL in males was longer and broader at lateral end than in females. Conclusion: Presence of at least one MFL in each knee joint, variations in anatomy in the form of presence of accessory bands and in size suggest the importance of identifying and differentiating these ligaments from the surrounding structures during radiological and arthroscopic examination for correct diagnosis and treatment. Presence of either MFLs in older subjects and both in younger subjects suggests degeneration of these ligaments with the advancement of age.