The medial meniscotibial ligament (medial coronary ligament) is the fibrous band attaching the periphery of the medial meniscus to the medial tibial plateau at its rim. It is part of the deep MCL (medial capsular ligament) and is considerably shorter and tighter than its lateral equivalent, limiting the medial meniscus to about 5 mm of anteroposterior movement. Its posterior part, which tethers the posterior horn, is the thickest and most distinct.
| Origin | Inferior peripheral margin of the medial meniscus |
|---|---|
| Insertion | Rim of the medial tibial plateau just below the articular margin |
Anchors the medial meniscus to the tibial rim, limits medial meniscal excursion during knee motion, and transmits medial compartment load through the meniscofemoral and meniscotibial surfaces simultaneously. Its tightness makes the medial meniscus more vulnerable to tearing from rotational loading.
The medial meniscotibial ligament is disrupted in peripheral medial meniscal tears and in medial compartment injuries involving the deep MCL. Detachment of its posterior part produces a ramp lesion, found in roughly 9-17% of ACL tears; it is identified by probing the posteromedial compartment and repaired through a posteromedial portal. The meniscotibial attachment must be preserved or repaired during medial meniscal surgery to restore the load-transmitting function of the meniscus. Capsular laxity at the meniscotibial attachment contributes to medial meniscal hypermobility and posterior horn instability.
Valgus stress disrupts the medial collateral ligament complex including the deep MCL and medial meniscotibial component, producing medial compartment instability and peripheral meniscal detachment that may need both ligament repair and meniscal reattachment.
Posterior peripheral detachment of the medial meniscus at the meniscotibial junction accompanying ACL injury, repaired with sutures through a posteromedial portal.
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