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Study finds high incidence of the anterior meniscofemoral ligament in ACL-deficient knees
In all cases, the fibers suspected to be the ligament were strong enough for simple traction to move the posterior horn of the lateral meniscus.
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A prospective study found a high incidence of the anterior meniscofemoral ligament of Humphry in patients with anterior cruciate ligament-deficient knees. However, the functional role and clinical importance of this ligament remain poorly understood, according to the study authors.
"It has been suggested that [the meniscofemoral ligaments] play a protective role by controlling the movement of the posterior horn of the lateral meniscus and by increasing the congruity of the meniscus and the condyle. Other authors have postulated that the MFLs (meniscofemoral ligaments) act as secondary restraints, supplementing the PCL (posterior cruciate ligament).
"Until the exact function and clinical relevance of the [anterior MFL] are determined, and given its high incidence of appearance, this structure should be preserved during meniscus and ligament surgeries," the study authors wrote.
Maximiliano Ranalletta, MD, and colleagues at Medicina del Deporte SA in Buenos Aries, Argentina, evaluated the incidence of the anterior MFL in 140 knees of 140 ACL reconstruction patients. They published their findings in Arthroscopy.
The study included 93 men and 47 women treated at a mean age of 30 years. Except for the ACL injury, no patients had any other degenerative changes, lateral meniscal injuries or previous surgeries, the authors noted.
To identify the anterior MFL, surgeons used radiofrequency and a motorized resector to debride synovial tissue from the anterior surface of the PCL before performing arthroscopic ACL reconstruction. During the evaluation, investigators paid close attention to any group of fibers connecting the posterior horn of the lateral meniscus to the medial femoral condyle. They then applied traction to those fibers and, if the posterior horn moved, they considered that structure an MFL, according to the study.
The researchers found that all knees had these fibers running anterior to the PCL. In addition, "In all cases, the group of fibers was strong enough for traction to cause movement of the posterior horn of the lateral meniscus," the authors reported.
"The [anterior MFL], or Humphry's ligament, was present as a constant structure in all 140 knees," they wrote.
Previous studies have reported wide variations in the incidence of the anterior MFL, partially due to differences in criteria used to define a ligament. Other investigators also evaluated patients with pathologic conditions that may be associated with MFL damage, they noted.
"In our study, although neither the thickness nor the length of these ligaments was measured, these structures were strong enough for simple traction to move the posterior horn of the lateral meniscus in all of the knees," the authors wrote.
For more information:
- Ranalletta M, Rossi W, Paterno M, et al. Incidence of the anterior meniscofemoral ligament: An arthroscopic study in anterior cruciate ligament-deficient knees. Arthroscopy. 2007;23:275-277.