Medial meniscotibial ligament

The medial meniscotibial ligament is a distinct, dense connective tissue structure that originates from the medial aspect of the tibial plateau and inserts onto the inferior edge of the medial meniscus. It corresponds at the lower portion of the of deep medial collateral ligament.

Histologically, it is composed of well-organized, parallel type I collagen fibers, with the highest density at its tibial attachment. There is a transition zone at the meniscal insertion where the collagen fibers become more disorganized and lack direct continuity with the meniscal tissue, resembling the joint capsule in fiber orientation. This transition zone is considered mechanically weaker and clinically relevant for ramp lesions.