The radiographic position of medial and lateral meniscal horns as a basis for meniscal reconstruction

This investigation attempted to determine the radiographic position of human meniscal horn bony insertion sites. This information would prove vital for anatomically correct osseous tunnel placement necessary for the restoration of a functional meniscus after reconstructive surgery. The native bony insertion sites of the medial and lateral meniscus in 13 fresh-frozen human cadaver knees were radiographically examined. After insertion site outline with 22-gauge fine wire, anteroposterior and lateral radiographs were obtained. Radiographic landmarks were then described in detail. Each meniscal horn was found to have a distinct bony insertion site with characteristic and consistent radiographic landmarks defining its margins. Using an arthroscopic guide, 3/32-inch fine wires were drilled into the center of the lateral (5 specimens) and medial (5 specimens) meniscal horns to validate these locations and to establish the clinical usefulness of these measures. Improved understanding of meniscal horn insertion site locations should improve osseous tunnel placements during meniscal transplantation. In the presence of a properly sized allograft, anatomically correct tunnel placement increases the liklihood of restoring normal meniscal function.