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Medial Meniscus vs Lateral Meniscus

Medial Meniscus vs Lateral Meniscus

The medial and lateral menisci are fibrocartilage structures that deepen the tibial plateaus and distribute load in the knee. Their different attachments and mobility explain why the medial meniscus is more commonly injured than the lateral meniscus.

Comparison Table

Feature
Medial Meniscus
Lateral Meniscus
Shape
C-shaped (semicircular)
More O-shaped (nearly circular)
Size
Larger, covers more tibial plateau
Smaller
Mobility
Less mobile (attached to MCL)
More mobile (not attached to LCL)
Capsular attachment
Firmly attached to joint capsule and MCL
Loosely attached, separated from LCL by popliteus tendon
Popliteus relationship
No direct relationship
Popliteus tendon passes through a hiatus in posterior attachment
Meniscofemoral ligaments
None
Has ligaments of Humphry (anterior) and Wrisberg (posterior)
Injury frequency
More commonly injured (3:1 ratio)
Less commonly injured
ACL tear association
Traditional "unhappy triad" (though may be less common)
More commonly injured with ACL tears (current evidence)
Blood supply zones
Red (peripheral), red-white (middle), white (inner) zones
Same zonal pattern
Healing potential
Peripheral (red) zone heals well; inner (white) zone heals poorly
Same - peripheral heals better than inner zone

Key Differences

  • Medial meniscus is C-shaped and firmly attached to MCL; lateral is O-shaped and more mobile
  • Medial is more commonly injured due to reduced mobility and MCL attachment
  • Lateral meniscus has meniscofemoral ligaments; medial does not
  • Popliteus tendon separates lateral meniscus from LCL

Clinical Relevance

  • MCL injuries often involve medial meniscus (attached together)
  • Joint line tenderness suggests meniscal pathology (medial or lateral)
  • McMurray test: Positive with click/pain suggests meniscal tear
  • Peripheral tears can heal and should be repaired; central tears often require partial meniscectomy

Study Tips

  • Medial Meniscus = More injury, MCL attachment, less Mobile
  • Lateral meniscus = Ligaments (meniscofemoral), Loose attachment, Less injury
  • Remember the blood supply zones: peripheral (red) heals, central (white) doesn't
  • Popliteus tendon creates a "gap" that separates the lateral meniscus from the LCL

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FAQs

Common questions about this comparison

The medial meniscus is firmly attached to the MCL and joint capsule, making it less mobile. During rotational stress or valgus force, the medial meniscus cannot move out of the way and gets trapped and torn between the femur and tibia. The lateral meniscus is more mobile and can move with the condyles.

Tear location is critical. Peripheral tears (red zone) have blood supply and can heal with repair. Central tears (white zone) are avascular and won't heal, so they are treated with partial meniscectomy. Tear pattern, patient age, and associated injuries also influence the decision.

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