Original article| Volume 21, ISSUE 12, P1468-1472, December 2005

Evaluation of the Neurosensory Function of the Medial Meniscus in Humans

      Purpose: Menisci are known to have receptors mainly concentrated at the anterior and posterior horns. Although they are purported to send afferent impulses to the central nervous system, this function has not been thoroughly evaluated. The purpose of the study was to investigate whether stimulation of the menisci initiates a cortical response. The reaction of the end organ to the reflex arc is also evaluated. Type of Study: Prospective case series. Methods: Fourteen patients with normal medial menisci were included in the study. Different parts of the knee joint (the posterior horn and the body of the medial meniscus, the medial femoral condyle, the capsule, and the joint space) were electrically stimulated by a probe during arthroscopy. The cortical response was monitored with somatosensory-evoked potentials (SEPs). The compound muscle action potentials (CMAPs) of the semimembranosus, quadriceps, and biceps femoris muscles were also monitored with electroneuromyography (ENMG). Results: Among the stimulated parts, only the posterior horn of the meniscus produced cortical responses. No response was obtained with stimulation of the medial femoral condyle, the body of the medial meniscus, the capsule, or the joint space. Stimulation of the posterior horn of the medial meniscus produced a measurable amount of CMAP latency for the semimembranosus muscle, but not for the quadriceps and biceps femoris muscles. Conclusions: Stimulation of the posterior horn of the medial meniscus produces reproducible cortical SEPs and results in ENMG-verified response of the semimembranosus muscle where no response of the semimembranosus muscle is detected with stimulation of the other parts of the knee. Clinical Relevance: The knowledge that only the horns of the medial meniscus have mechanoreceptors in the medial compartment of the knee helps to understand patients’ signs and symptoms in medial compartment disease.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Solomonow M.
        • Baratta R.
        • Zhou B.H.
        • Shoji H.
        • Beck W.B.C.
        • D’ambrosia R.
        The synergistic action of the anterior cruciate ligament and thigh muscles in maintaining joint stability.
        Am J Sports Med. 1987; 15: 207-213
        • Pitman M.I.
        • Nainzadeh N.
        • Menche D.
        • Gasalberti R.
        • Song E.K.
        The intraoperative evaluation of the neurosensory function of the anterior cruciate ligament in humans using somatosensory evoked potentials.
        Arthroscopy. 1992; 8: 442-447
        • Schultz R.A.
        • Miller D.C.
        • Kerr C.S.
        • Micheli L.
        Mechanoreceptors in human cruciate ligaments.
        J Bone Joint Surg Am. 1984; 66: 1072-1076
        • Mine T.
        • Kimura M.
        • Sakka A.
        • Kawai S.
        Innervation of nociceptors in the menisci of the knee joint.
        Arch Orthop Trauma Surg. 2000; 120: 201-204
        • O’Connor B.L.
        • Mc Connaughey J.S.
        The structure and innervation of cat knee menisci and their relation to a “sensory hypothesis” of meniscal function.
        Am J Anat. 1978; 153: 431-442
        • Zimny M.L.
        • Albright D.J.
        • Dabezies E.
        Mechanoreceptors in the human medial meniscus.
        Acta Anat. 1988; 133: 35-40
        • Dawson G.P.
        The cerebral response to electrical stimulation of the peripheral nerve in man.
        J Neurol Neurosurg Psychiatry. 1947; 10: 134-140
        • Karahan M.
        • Yalcin S.
        • Saygi B.
        • Cabukoglu C.
        The role of meniscal nerve fibers in the proprioceptive function of the knee. 1998 (Presented at the 8th Congress of ESSKA, Nice, France, April 29-May 2)
        • Gray J.C.
        Neural and vascular anatomy of the menisci of the human knee.
        J Orthop Sports Phys Ther. 1999; 29: 23-30
        • Kaplan E.B.
        Some aspects of functional anatomy of the human knee joint.
        Clin Orthop. 1962; 23: 18-29
        • Scuderi G.R.
        • Scott W.N.
        • Insall J.N.
        Injuries of the knee.
        in: Rockwood C.A. Green D.P. Bucholz R.W. Heckman J.D. Fractures in adults. Lippincott-Raven, Philadelphia1996: 2001-2126
        • Thompson W.O.
        • Thaete F.L.
        • Fu F.H.
        • Dye S.F.
        Tibial meniscal dynamics using three-dimensional reconstruction of magnetic resonance images.
        Am J Sports Med. 1991; 19: 210-215
        • Durand A.
        • Richards C.L.
        • Malouin F.
        • Bravo G.
        Motor recovery after arthroscopic partial meniscectomy.
        J Bone Joint Surg Am. 1993; 75: 202-214