Evidence map›Paper›PMID 40949534›Full record

ArticleOrthopaedic journal of sports medicine2025

Pediatric Meniscotibial Ligament Complex Anatomy and Biomechanics.

Willemijn H van Deursen, Thomas M Johnstone, Annelisse Cuellar-Montes, David Rogerson Williams Baird, Calvin K Chan, Ian Hollyer, Matthew S Rohde, Marc Tompkins, Henry B Ellis, Theodore J Ganley and 6 more

Abstract read
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In one paragraph

Article in Orthopaedic journal of sports medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Willemijn H van DeursenStanford University School of Medicine, Stanford, California, USA.ORCID https://orcid.org/0000-0003-4270-1932
Thomas M JohnstoneStanford University School of Medicine, Stanford, California, USA.
Annelisse Cuellar-MontesStanford University School of Medicine, Stanford, California, USA.
David Rogerson Williams BairdStanford University School of Medicine, Stanford, California, USA.
Calvin K ChanDepartment of Orthopaedic Surgery, Stanford University, Stanford, California, USA.
Ian HollyerDepartment of Orthopaedic Surgery, Stanford University, Stanford, California, USA.
Matthew S RohdeDepartment of Orthopaedic Surgery, Stanford University, Stanford, California, USA).
Marc TompkinsDepartment of Orthopedic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.ORCID https://orcid.org/0000-0002-8641-3150
Henry B EllisDepartment of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Theodore J GanleyDivision of Orthopaedics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Yi-Meng YenOrthopedics and Sports Medicine Department, Boston Children's Hospital, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-1306-4201
Matthew R SchmitzDepartment of Orthopaedics, Rady Children's Hospital San Diego, San Diego, California, USA.
Nicole S PhamDepartment of Orthopaedic Surgery, Stanford University, Stanford, California, USA.
Seth L ShermanDepartment of Orthopaedic Surgery, Stanford University, Stanford, California, USA.
Marc LevenstonDepartment of Mechanical Engineering, Stanford University, Stanford, California, USA.
Kevin G SheaDepartment of Orthopaedic Surgery, Stanford University, Stanford, California, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Meniscal repair is increasingly performed in pediatric patients, with capsular-based techniques remaining the gold standard despite limitations such as high failure rates and risk of meniscal extrusion. Recent studies highlight the potential role of accessory knee ligaments in improving meniscal stability and repair outcomes. The meniscotibial ligament complex (MTLC) has emerged as a potential area of interest to produce more normal anatomic and biomechanical meniscal function in meniscal repair. Purpose: To evaluate the native anatomy and biomechanical strength of the MTLC of the medial and lateral meniscus of pediatric knees. Study Design: Descriptive laboratory study. Methods: Fourteen fresh-frozen pediatric human knees (mean age, 7.5 years; range, 5-10 years; 6 male, 8 female) were used in this study. The depth of the recess between the MTLC and the meniscocapsular complex was measured. Subsequently, the medial and lateral menisci were divided into approximate thirds, creating anterior, central, and posterior testing zones for each meniscus. Each meniscus/MTLC complex underwent monotonic load-to-failure testing on an Instron 5944 test frame with a 2-kN load cell with load applied superiorly. Biomechanical properties were analyzed using linear mixed models with donor as a random factor and aspect (medial/lateral) and position (anterior/central/posterior) as fixed factors. Results: The posterior recess depth was significantly larger (mean, 5.4 mm; 95% CI, 4.6-6.3 mm) than anterior (mean, 3.4 mm; 95% CI, 2.6-4.2 mm) ( Conclusion: This study defines a clear space in which the MTLC is distinct from the joint capsule, which is deepest in the posterior third of the medial and lateral meniscus. Our results demonstrate that the posterior region of the MTLC can withstand higher loads than the anterior region in pediatric knees. Clinical Relevance: These findings offer foundational insights into the native anatomy and biomechanics of the MTLC, guiding future studies involving the MTLC in meniscal repair. This knowledge may be particularly relevant to ramp lesions, other posterior meniscal tear patterns, and meniscal transplants.

Indexed as

coronary ligamentmeniscal instabilitymeniscal repairmeniscal tearmeniscotibial ligament complexmeniscus

Identifiers

PMID40949534
PMCPMC12426389

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.