Meniscus insertion anatomy as a basis for meniscus replacement: a morphological cadaveric study.

A morphological cadaveric study was carried out to gain exact data concerning location, shape, and size of the meniscal insertions to bone. Ninety-two knee joints were dissected (46 donors; age 18 to 58 years). Peripheral length of the menisci, including their insertion ligaments, was measured. The peripheral length was 111 +/- 14 mm for the medial and 111 +/- 10 for the lateral meniscus. The tibial insertion ligaments for the medial meniscus were fixed in areas that could be defined by bony landmarks. The posterior insertion area measured 80 +/- 10 mm2, the anterior insertion area measured 139 +/- 43 mm2. Bony tibial insertions of the lateral meniscus were less well defined. The posterior meniscofemoral ligament (Wrisberg) was found in 76% of the knees; the anterior meniscofemoral ligament (Humphry) was found in 50% of the specimens. The meniscofemoral ligaments in the right knee and the left knee of the same individual were frequently different. The anterior transverse ligament was found in 64% of the specimens. We concluded that an anatomical attachment of a medial meniscus substitute should be possible but to restore the lateral meniscus anatomically would be far more complicated.