Abstract Purpose To evaluate the effect of the meniscofemoral ligament (MFL) in maintaining lateral compartment contact pressures following injury to the posterior root of the lateral meniscus and to measure the ability of restoring intraarticular loads to normal by repairing the posterior root to the tibia following transection of the posterior root and the MFL. Methods Ten human cadaveric knee joints were axially loaded to 100 N. A digital pressure sensor measured the contact pressure in the lateral compartment. Five different conditions were tested: intact; following release of the posterior root of the lateral meniscus; following transection of the MFL along with release of the posterior root; refixing the posterior root of the lateral meniscus to the tibia using an anatomical transosseous tunnel; refixing the root of the lateral meniscus using a tibial ACL tunnel. Results After transection of the posterior lateral meniscus root the contact pressure did not increase significantly. The additional transection of the MFL leads to a significant increase of the contact pressure. Anatomical fixation of the meniscus posterior horn reduces the femorotibial pressure to nearly pre-sectioning values. The reattachment of the meniscus posterior horn via a tibial ACL tunnel is equivalent to an anatomical fixation. Conclusion In case of a root tear of the lateral meniscus the MFL maintains meniscus function and stabilizes the pressure in the lateral compartment in case of a root tear. A complete detachment of the posterior meniscus horn (MFL and root tear) leads to an increase of the intraarticular pressure. A root repair normalizes the pressure down to normal values. The tibial ACL tunnel is suitable to perform the repair and to lead out the suture. Clinical relevance In case of a complete detachment of the meniscus posterior horn a fixation of the posterior root is necessary to restore the meniscus function and to guarantee an equal pressure distribution in the lateral compartment. It can be combined with an ACL reconstruction.