[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]

Abstract

1. To understand the meniscus-tears the architecture of their collagenic fibers is of interest, particularly so the connection of the fibers of the medial meniscus with the collateral ligament. 2. The ligaments of 12 knee joints have been studied macroscopically and with the aid of thick serial sections under polarized light. 3. The main portion of the tibial collateral ligament passes the articular space without any connection with the capsule or the meniscus. The upper oblique portion of the ligament runs inside the external zone of the meniscus to the posterior attachment of the latter. Immediately inferior to the articular space the oblique fibers have another attachment. 4. The findings in respect of the arrangement of the fibers in the menisci differ from those in earlier studies. Only in the external zone the fibers run approximately parallel to the outer border. After leaving the external zone the fibers run in an arched way through the middle zone. In the internal zone these fibers have nearly a radial direction. 5. The architecture of the menisci is discussed under functional aspects. It does not correspond to a "spring" but to a tendon, which is extended over a hypomochlion. 6. Forms and localisations of meniscus-tears have been discussed under viewpoint of architecture and compared with clinical results: The typical tear of the posterior segment of the medial meniscus is the horizontal cleavage. The present opinion according to which longitudinal tears are the typical meniscus lesion, seems to be doubtful.