Evaluation of age-dependent morphometrics of the meniscofemoral ligaments in reference to the posterior cruciate ligament in routine MRI

OBJECTIVES: To quantify the morphological correlation between the posterior cruciate ligament (PCL) and the meniscofemoral ligaments (MFLs), to propose normal ranges for different age populations, and to define guidelines for correct identification and differentiation of MFLs in routine MRI. METHODS: Three hundred forty-two subjects were included retrospectively and subdivided into five age groups. Morphometrics of the PCL and the MFLs were measured on standard MRI in the sagittal, coronal, and axial planes. Student’s t test, Mann-Whitney U test, and ANOVA and Kruskal-Wallis tests with Bonferroni correction were used for comparison. RESULTS: The MFLs did not vary significantly between sexes (p > 0.05) or in those older than 10 years (p > 0.05). Longitudinal MFL growth is completed before age 11 years, with cross-sectional area (CSA) increasing until age 20. The CSA of the PCL was significantly (p = 0.028) larger in knees without a pMFL (Mdn = 39.7 mm(2)) than with a pMFL (Mdn = 35.4 mm(2)). MFLs were more often detected on sagittal than coronal images. CONCLUSIONS: This study describes the morphometric relation between the PCL and the MFLs on routine MRI. When reporting imaging findings in preparation for arthroscopic knee surgery, evaluation of MFLs, first in the sagittal and then the coronal plane, will achieve the best results. KEY POINTS: • The MFLs and the PCL have distinct morphological patterns throughout life. • These patterns show intimate anatomical relationships and a potential biomechanical impact. • Those patterns and relationships can be quantified with MRI. • A correlation exists between age and morphometrics of the MFLs. • Recommendations for correct identification of the MFLs are provided.