Abstract:

Background: The meniscofibular ligament (MFL) — a capsular structure linking the posterior/lateral meniscus to the fibular head — has received growing clinical and anatomical attention over the last decade. Historically under-recognised, the MFL is increasingly implicated in posterolateral knee stability, lateral meniscal mobility, and persistent posterolateral knee pain after injury. Understanding its anatomy, biomechanics, imaging appearance, and patterns of injury is essential for knee surgeons, radiologists and physiotherapists involved in diagnosis and management.

Objective: To synthesise current knowledge (2015–2025) on MFL anatomy, function, imaging, mechanisms of injury, clinical presentation, management strategies and outcomes, and to identify gaps for future research.

Methods: A targeted review of PubMed, Google Scholar and recent specialist orthopaedic journals was performed to identify anatomical studies, imaging series, case reports, arthroscopic technique descriptions and biomechanical investigations concerning the MFL and adjacent posterolateral structures. Priority was given to publications between 2015 and 2025; earlier foundational anatomical work was also included to provide historical context. Key findings from systematic and narrative reviews, cadaveric dissections and recent surgical technique papers were synthesised narratively.

Results & conclusions: The MFL originates from the inferolateral margin or posterior horn region of the lateral meniscus and inserts at the fibular head; it courses anterior to the popliteus tendon and deep to parts of the posterolateral complex. Cadaveric and imaging studies suggest MFL prevalence and morphology vary, but it can be visualised on high-resolution MRI and arthroscopy. Biomechanically, the MFL contributes to limiting excessive radial and anterior translation of the lateral meniscus and aids posterolateral corner stability, particularly in terminal extension. Isolated MFL injuries are uncommon; MFL disruption frequently co-occurs with lateral meniscal tears, popliteomeniscal fascicle injuries, or posterolateral corner (PLC) lesions and may contribute to persistent lateral pain and mechanical symptoms. Management ranges from conservative rehabilitation to arthroscopic repair or adjunct PLC reconstruction in combined instability. Evidence is largely observational and anatomical; prospective clinical outcome studies and standardised imaging/arthroscopic classification systems are needed.

Keywords:

meniscofibular ligament, MFL injuries, posterolateral corner lesions

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