Skip to main content
SpringerLink
Log in

Meniscal Anatomy

  • Chapter
  • First Online:
Meniscal Injuries

Abstract

The menisci are fibrocartilaginous structures within the knee joint that play important roles in the normal function of the knee. The menisci arise from mesenchymal progenitor cells in the limb bud and become distinct structures by the 8th week of gestation. The fibrochondrocyte is the primary cell type of the meniscus, and these cells are arranged in a complex manner which, along with the extracellular matrix, forms the basis of the mechanical properties of the meniscus. The extracellular matrix is composed of ~ 70 % water and ~30 % collagen and proteoglycans. The medial and lateral menisci differ in size and shape, and their dimension is correlated to gender, height, and weight. The menisci are attached within the joint primarily by bony attachments of the anterior and posterior horns with accessory structures providing some stability. The medial meniscus has more soft tissue and bony connections than does the lateral meniscus and, therefore, plays a more important role in joint stability. While the entire meniscus is vascular early in development, the vascular supply in the adult meniscus occurs only in the periphery which has important implications in the treatment of meniscal tears. The majority of the meniscus is void of any neural elements; however, mechanoreceptors and sensory fibers can be found in the periphery and contribute to proprioception of the knee and along with capsular irritation, the cause of pain in meniscal tears.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Gardner E, O’Rahilly R. The early development of the knee joint in staged human embryos. J Anat. 1968;102(Pt 2):289–99.

    PubMed  CAS  Google Scholar 

  2. Hyde G, Boot-Handford RP, Wallis GA. Col2a1 lineage tracing reveals that the meniscus of the knee joint has a complex cellular origin. J Anat. 2008;213(5):531–8.

    PubMed  CAS  Google Scholar 

  3. Gray DJ, Gardner E. Prenatal development of the human knee and superior tibiofibular joints. Am J Anat. 1950;86(2):235–87.

    Article  PubMed  CAS  Google Scholar 

  4. O’Rahilly R. The early prenatal development of the human knee joint. J Anat. 1951;85(2):166–70.

    PubMed  Google Scholar 

  5. Clark CR, Ogden JA. Development of the menisci of the human knee joint. Morphological changes and their potential role in childhood meniscal injury. J Bone Joint Surg Am. 1983;65(4):538–47.

    PubMed  CAS  Google Scholar 

  6. McDevitt CA, Webber RJ. The ultrastructure and biochemistry of meniscal cartilage. Clin Orthop Relat Res. 1990;252:8–18.

    PubMed  Google Scholar 

  7. Cheung HS. Distribution of type I, II, III and V in the pepsin solubilized collagens in bovine menisci. Connect Tissue Res. 1987;16(4):343–56.

    Article  PubMed  CAS  Google Scholar 

  8. Messner K, Gao J. The menisci of the knee joint. Anatomical and functional characteristics, and a rationale for clinical treatment. J Anat. 1998;193(Pt 2):161–78.

    Article  PubMed  CAS  Google Scholar 

  9. Hellio Le Graverand MP, et al. The cells of the rabbit meniscus: their arrangement, interrelationship, morphological variations and cytoarchitecture. J Anat. 2001;198(Pt 5):525–35.

    Article  PubMed  CAS  Google Scholar 

  10. Ghadially FN, et al. Ultrastructure of rabbit semilunar cartilages. J Anat. 1978;125(Pt 3):499–517.

    PubMed  CAS  Google Scholar 

  11. Petersen W, Tillmann B. Collagenous fibril texture of the human knee joint menisci. Anat Embryol (Berl). 1998;197(4):317–24.

    Article  CAS  Google Scholar 

  12. Wagner HJ. Architecture of collagen fibers in the meniscus of the human knee joint, with special reference to the medial meniscus and its connection to the articular ligaments. Z Mikrosk Anat Forsch. 1976;90(2):302–24.

    PubMed  CAS  Google Scholar 

  13. Beaupre A, et al. Knee menisci. Correlation between microstructure and biomechanics. Clin Orthop Relat Res. 1986;208:72–5.

    PubMed  Google Scholar 

  14. Bullough PG, et al. The strength of the menisci of the knee as it relates to their fine structure. J Bone Joint Surg Br. 1970;52(3):564–7.

    PubMed  CAS  Google Scholar 

  15. Shrive NG, O’Connor JJ, Goodfellow JW. Load-bearing in the knee joint. Clin Orthop Relat Res. 1978;131:279–87.

    PubMed  Google Scholar 

  16. Ghosh P, Taylor TK. The knee joint meniscus. A fibrocartilage of some distinction. Clin Orthop Relat Res. 1987;224:52–63.

    PubMed  Google Scholar 

  17. Pierschbacher MD, Hayman EG, Ruoslahti E. The cell attachment determinant in fibronectin. J Cell Biochem. 1985;28(2):115–26.

    Article  PubMed  CAS  Google Scholar 

  18. Adams ME, Muir H. The glycosaminoglycans of canine menisci. Biochem J. 1981;197(2):385–9.

    PubMed  CAS  Google Scholar 

  19. Atencia LJ, et al. Cartilage content of an immature dog. Connect Tissue Res. 1989;18(4):235–42.

    Article  PubMed  CAS  Google Scholar 

  20. Van Thiel GS, et al. Meniscal allograft size can be predicted by height, weight, and gender. Arthroscopy. 2009;25(7):722–7.

    Article  PubMed  Google Scholar 

  21. Berlet GC, Fowler PJ. The anterior horn of the medical meniscus. An anatomic study of its insertion. Am J Sports Med. 1998;26(4):540–3.

    PubMed  CAS  Google Scholar 

  22. Johnson DL, et al. Insertion-site anatomy of the human menisci: gross, arthroscopic, and topographical anatomy as a basis for meniscal transplantation. Arthroscopy. 1995;11(4):386–94.

    Article  PubMed  CAS  Google Scholar 

  23. Greis PE, et al. Meniscal injury: I. Basic science and evaluation. J Am Acad Orthop Surg. 2002;10(3):168–76.

    PubMed  Google Scholar 

  24. Thompson WO, et al. Tibial meniscal dynamics using three-dimensional reconstruction of magnetic resonance images. Am J Sports Med. 1991;19(3):210–5. discussion 215-6.

    Article  PubMed  CAS  Google Scholar 

  25. Levy IM, et al. The effect of lateral meniscectomy on motion of the knee. J Bone Joint Surg Am. 1989;71(3):401–6.

    PubMed  CAS  Google Scholar 

  26. Simonian PT, et al. Popliteomeniscal fasciculi and lateral meniscal stability. Am J Sports Med. 1997;25(6):849–53.

    Article  PubMed  CAS  Google Scholar 

  27. Rao SK, Sripathi RP. Clinical, radiologic and arthroscopic assessment and treatment of bilateral discoid lateral meniscus. Knee Surg Sports Traumatol Arthrosc. 2007;15(5):597–601.

    Article  PubMed  Google Scholar 

  28. Aichroth PM, Patel DV, Marx CL. Congenital discoid lateral meniscus in children. A follow-up study and evolution of management. J Bone Joint Surg Br. 1991;73(6):932–6.

    PubMed  CAS  Google Scholar 

  29. Bellier G, et al. Lateral discoid menisci in children. Arthroscopy. 1989;5(1):52–6.

    Article  PubMed  CAS  Google Scholar 

  30. Pellacci F, et al. Lateral discoid meniscus: treatment and results. Arthroscopy. 1992;8(4):526–30.

    Article  PubMed  CAS  Google Scholar 

  31. Ikeuchi H. Arthroscopic treatment of the discoid lateral meniscus. Technique and long-term results. Clin Orthop Relat Res. 1982;167:19–28.

    PubMed  Google Scholar 

  32. Dickhaut SC, DeLee JC. The discoid lateral-meniscus syndrome. J Bone Joint Surg Am. 1982;64(7):1068–73.

    PubMed  CAS  Google Scholar 

  33. Wojtys EM, Chan DB. Meniscus structure and function. Instr Course Lect. 2005;54:323–30.

    PubMed  Google Scholar 

  34. Kocher MS, Klingele K, Rassman SO. Meniscal disorders: normal, discoid, and cysts. Orthop Clin North Am. 2003;34(3):329–40.

    Article  PubMed  Google Scholar 

  35. Nelson EW, LaPrade RF. The anterior intermeniscal ligament of the knee. An anatomic study. Am J Sports Med. 2000;28(1):74–6.

    PubMed  CAS  Google Scholar 

  36. Zivanovic S. Menisco-meniscal ligaments of the human knee joint. Anat Anz. 1974;135(1–2):35–42.

    PubMed  CAS  Google Scholar 

  37. Arnoczky SP, Warren RF. Microvasculature of the human meniscus. Am J Sports Med. 1982;10(2):90–5.

    Article  PubMed  CAS  Google Scholar 

  38. Dye SF, Vaupel GL, Dye CC. Conscious neurosensory mapping of the internal structures of the human knee without intraarticular anesthesia. Am J Sports Med. 1998;26(6):773–7.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, 3400 Spruce Street, 2 Silverstein, Philadelphia, PA, 19104, USA

    Stephen J. Torres M.D., B.S. & Jason E. Hsu M.D.

  2. Mckay Orthopaedic Research Laboratory, University of Pennsylvania, Philadelphia, PA, 19104, USA

    Robert L. Mauck Ph.D.

Authors
  1. Stephen J. Torres M.D., B.S.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jason E. Hsu M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Robert L. Mauck Ph.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Stephen J. Torres M.D., B.S. .

Editor information

Editors and Affiliations

  1. Hospital of the Uni. of Pennsylvania, Philadelphia, Pennsylvania, USA

    John D. Kelly, IV

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer Science+Business Media New York

About this chapter

Cite this chapter

Torres, S.J., Hsu, J.E., Mauck, R.L. (2014). Meniscal Anatomy. In: Kelly, IV, J. (eds) Meniscal Injuries. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8486-8_1

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-8486-8_1

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8485-1

  • Online ISBN: 978-1-4614-8486-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation