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 medial capsular ligament and is considerably shorter and tighter than its lateral equivalent, contributing to the relative immobility of the medial meniscus compared to the lateral. The deep MCL also blends with the peripheral medial meniscus through the meniscocapsular attachment.
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. The meniscotibial attachment must be preserved or repaired during medial meniscal surgery to restore the load-transmitting function of the meniscus. In medial collateral ligament reconstruction, the deep MCL and its meniscotibial component are reconstructed to prevent valgus laxity. 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 requires both ligament repair and meniscal reattachment to restore medial knee stability.
