The medial meniscus is attached to the joint capsule of the knee via a fibrous structure called the coronary ligament. Which anatomical layer of the meniscus is this attachment most firmly anchored to?

Explanation

## Meniscal Attachments and the Coronary Ligament **Key Point:** The coronary ligament is a fibrous attachment of the meniscus to the joint capsule, and it is anchored most firmly to the **peripheral (outer) border** of the meniscus, not the free inner edge. ### Anatomical Organization of the Meniscus The meniscus has three distinct borders: | Border | Location | Attachment | Function | |--------|----------|-----------|----------| | **Peripheral (Outer)** | Attached to joint capsule | Coronary ligament, firm attachment | Vascular supply, stability | | **Central (Inner)** | Free edge in joint space | No capsular attachment | Mobility, load distribution | | **Anterior & Posterior** | Horns of meniscus | Attached to intercondylar area | Rotational stability | ### The Coronary Ligament 1. **Definition:** Short, thick fibrous bands connecting the peripheral margin of the meniscus to the fibrous joint capsule 2. **Location:** Runs circumferentially around the outer edge of the meniscus 3. **Function:** - Provides vascular supply to the outer third of the meniscus ("red zone") - Stabilizes the meniscus during knee motion - Allows limited meniscal mobility **High-Yield:** The meniscus has three vascular zones: - **Red zone (outer third):** Well vascularized via coronary ligament; heals well if torn - **Red-white zone (middle third):** Partially vascularized; variable healing - **White zone (inner third):** Avascular; poor healing potential ### Clinical Significance **Clinical Pearl:** Meniscal tears in the peripheral (red) zone have better healing potential because the coronary ligament provides blood supply. Tears in the inner (white) zone are less likely to heal and often require meniscectomy. **Warning:** The inner free edge of the meniscus is NOT attached to the capsule—this is why the meniscus can move and deform during knee motion. Confusion between peripheral and central borders is a common exam trap. [cite:Gray's Anatomy 42e Ch 6, Clinically Oriented Anatomy Moore 9e Ch 6]