Anatomical and Morphological Variations of Menisci with Relation to the Anterior Cruciate Ligament Tibial Insertion and its Clinical Significance: A Human Cadaveric Study

Background: The knee joint is highly prone to injury, particularly involving the anterior cruciate ligament (ACL) and menisci. Anatomical variations in meniscal morphology and their relationship to the ACL tibial insertion (ACLTI) and tibial plateau may influence injury patterns and surgical outcomes. This study aimed to evaluate the morphological and morphometric variations of the menisci in relation to the ACLTI and tibial plateau surface area and to highlight their clinical significance. Materials and Methods: Thirty-four lower limbs from formalin-fixed adult cadavers (68 menisci and 34 ACLTIs) were dissected. Meniscal dimensions, horn attachment sites, ACL measurements, and tibial plateau surface areas were measured using digital calipers. Meniscal shape types were recorded. Statistical analysis was performed using Student’s t -test and ANOVA, with significance set at P < 0.05. Results: Five meniscal morphological types were identified: Crescent semilunar, C-shaped, U-shaped, sickle, and V-shaped. The medial meniscus showed significantly greater dimensions than the lateral meniscus (LM). The medial tibial plateau was significantly longer than the lateral plateau ( P < 0.05). Distances between the ACLTI and the medial meniscal horns were significantly greater than those of the LM ( P < 0.05). Conclusion: The findings demonstrate a close anatomical and morphometric relationship between meniscal horn attachments and the ACLTI. Awareness of these anatomical variations is important for accurate surgical planning and outcomes in procedures such as ACL reconstruction and meniscal allograft transplantation.