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# Meniscus roots

The meniscus roots are short ligaments that anchor the ends of each meniscus to the [tibia](https://durgical.com/en/anatomy/tibia/); a torn root lets the meniscus slip out.

Official name: Meniscotibial (coronary) ligaments and meniscal roots

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## What it is

Short ligaments (meniscus roots) anchoring the ends of each meniscus to the tibia.

## What it does

Hold the menisci in place so they can spread the load. Root tears can make a meniscus stop working.

## Key points

- Posterior root tear of the [medial meniscus](https://durgical.com/en/anatomy/medial-meniscus/): typical in middle-aged and older people, often after a minor squat; it can lead to rapid medial arthritis
- Posterior root tears of the [lateral meniscus](https://durgical.com/en/anatomy/lateral-meniscus/) typically come with ACL tears
- Front-to-back order in the intercondylar area: medial anterior horn, ACL, lateral anterior horn, lateral posterior horn, medial posterior horn, PCL
- The lateral coronary ligament has a gap, the popliteal hiatus, where the popliteus tendon passes

## Key facts

**Attaches**
Meniscal roots: anterior and posterior horns to tibial intercondylar area; coronary ligaments: meniscal rims to tibial margin

**Function**
Anchor menisci to tibia; keep hoop tension so menisci share load; root tear acts like total meniscectomy

## Relations

**In front**
ACL tibial attachment between the two anterior roots; the lateral anterior root blends with it

**Behind**
PCL behind the medial posterior root; the meniscofemoral ligaments leave the lateral posterior horn beside the PCL

**Lateral**
[Popliteus tendon](https://durgical.com/en/anatomy/tendon-of-popliteus/) passing through the hiatus in the lateral coronary ligament

**Below**
Tibial intercondylar area (roots) and the rim of the tibial plateau just below the articular cartilage (coronary ligaments)

## How to find it

Not palpable. At arthroscopy the anterior roots are seen at the front of the intercondylar area beside the ACL; the posterior roots are viewed through the notch or a posteromedial portal. The coronary ligaments show when the meniscal edge is lifted with a probe.

## On imaging

MRI signs of a root tear: a vertical bright cleft at the root on coronal images, an absent posterior horn on sagittal images (ghost meniscus sign), and the meniscus pushed out 3 mm or more beyond the tibial edge (extrusion). Medial root tears may come with a subchondral insufficiency fracture of the medial femoral condyle.

## Clinical notes

- Root repair (for example a transtibial pull-out suture) aims to restore hoop tension and protect the cartilage
- Drilling the ACL tibial tunnel can damage the lateral anterior root, which lies right next to it
- Coronary ligament tears let the meniscus extrude or move too much, even when the meniscus itself is intact

## Related conditions

- [Meniscus Tear](https://durgical.com/en/conditions/meniscus-tear/)

## Test yourself

Think of the answer, then tap the question to see it.

## Why does a posterior root tear of a meniscus behave like a total meniscectomy?

It destroys hoop tension, so the meniscus no longer shares load; medial root tears can lead to rapid medial arthritis.

## Which tear typically comes with a posterior root tear of the lateral meniscus?

An ACL tear.

## What are the MRI signs of a meniscal root tear?

A vertical bright cleft at the root, an absent posterior horn (ghost meniscus sign) and extrusion of 3 mm or more.

## Where does the popliteus tendon pass through the lateral coronary ligament?

Through a gap in the lateral coronary ligament, the popliteal hiatus.

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## Its names

**Official Latin (TA2)**
ligamentum meniscotibiale laterale; ligamentum meniscotibiale mediale TA2 1901

**Official Spanish (DeCS)**
Ligamentos meniscotibiales

**English (TA2)**
Meniscotibial (coronary) ligaments and meniscal roots

**Also called**
lateral coronary ligament · medial coronary ligament

## Related

- [ACL](https://durgical.com/en/anatomy/anterior-cruciate-ligament/)
- [PCL](https://durgical.com/en/anatomy/posterior-cruciate-ligament/)
- [Medial meniscus](https://durgical.com/en/anatomy/medial-meniscus/)
- [Lateral meniscus](https://durgical.com/en/anatomy/lateral-meniscus/)
- [Femur](https://durgical.com/en/anatomy/femur/)
- [Tibia](https://durgical.com/en/anatomy/tibia/)

Sources: Terminologia Anatomica (TA2); [Anatomy, Bony Pelvis and Lower Limb: Medial Meniscus](https://www.ncbi.nlm.nih.gov/books/NBK537276/); [Anatomy, Bony Pelvis and Lower Limb, Knee Lateral Meniscus](https://www.ncbi.nlm.nih.gov/books/NBK519494/).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/anatomy/meniscotibial-ligaments-and-meniscal-roots/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/meniscotibial-ligaments-and-meniscal-roots/