The lateral meniscotibial (coronary) ligament is the inferior portion of the joint capsule connecting the inferior border of the lateral meniscus to the tibial plateau rim around the lateral compartment. Unlike the medial coronary ligament which firmly anchors the medial meniscus, the lateral coronary ligament is looser and allows greater lateral meniscal translation — the lateral meniscus can translate up to 11 mm posteriorly with knee flexion, while the medial meniscus moves only 5-6 mm.
Loosely tethers the lateral meniscus to the lateral tibial plateau, allowing greater posterior translation during knee flexion than the tighter medial side, facilitating the screw-home mechanism of the knee.
The lateral coronary ligament laxity explains why lateral meniscal tears are less common despite greater range of meniscal motion: the meniscus can move freely without tearing. However, when the lateral coronary ligament is disrupted or tightened by scarring (after lateral meniscal repair or meniscectomy), abnormal meniscal kinematics result. The lateral coronary ligament is released in lateral meniscal posterior horn repair to improve posterior horn mobility. Discoid lateral meniscus pathology is associated with abnormal coronary ligament attachments in the Wrisberg variant.
Lateral meniscal posterior horn tears repaired arthroscopically may require release of the lateral coronary ligament to allow the posterior horn to be mobilised and anatomically repositioned for inside-out or all-inside suture repair; adequate posterior horn mobilisation prevents tension on the repair sutures that causes early failure.
