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Knee Surgery, Sports Traumatology, Arthroscopy
Published in: Knee Surgery, Sports Traumatology, Arthroscopy 8/2017

01-08-2017 | Knee

Morphology of insertion sites on patellar side of medial patellofemoral ligament

Authors: Shuhei Kikuchi, Goro Tajima, Jun Yan, Youichi Kamei, Moritaka Maruyama, Atsushi Sugawara, Kotaro Fujino, Sanjuro Takeda, Minoru Doita

Published in: Knee Surgery, Sports Traumatology, Arthroscopy | Issue 8/2017

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Abstract

Purpose

The purpose of this study was to clarify the insertion sites on the patellar side of the medial patellofemoral ligament (MPFL).

Methods

A total of 35 nonpaired human cadaveric knees were used in this study. After identification of the MPFL, the insertion sites on the patellar side of the MPFL were marked. Three-dimensional images were created, and the location and morphology of these insertion sites were analysed.

Results

The morphology of the insertion sites on the patellar side of the MPFL was consistent. The proximal fibres of the MPFL were inserted to the deep fascia of the vastus medialis obliquus (VMO) and medial margin of the vastus intermedius (VI). The distal fibres of the MPFL were inserted to the medial margin of the patella directly. The insertion lengths of the VMO, VI, and patella were 26.7 ± 5.0, 28.5 ± 4.4, and 18.5 ± 4.4 mm, respectively. The rate of the vertical distance from the superior pole of the patella to the superior edge of the MPFL in relation to the total patellar height was 12 ± 4.4 %. At the distal edge, the rate was 58 ± 9.6 %.

Conclusion

The insertion sites on the patellar side of the MPFL were consistent. The MPFL inserted into the VMO and VI was significantly longer than into the patella. The clinical relevance of this study is to improve understanding of the anatomy of the insertion sites on the patellar side of the MPFL and the pathophysiology of patellar dislocation.
Literature
1.
Ahmad CS, Stein BE, Matuz D, Henry JH (2000) immediate surgical repair of the medial patellar stabilizers for acute patellar dislocation. A review of eight cases. Am J Sports Med 28(6):804–810CrossRefPubMed
2.
Amis AA, Firer P, Mountney J, Senavongse W, Thomas NP (2003) Anatomy and biomechanics of the medial patellofemoral ligament. Knee 10(3):215–220CrossRefPubMed
3.
Aragao J, Reis F, Vasconcelos D, Feitosa V, Nunes M (2008) Metric measurements and attachment levels of the medial patellofemoral ligament: an anatomical study in cadavers. Clinics 63(4):541–544CrossRefPubMedPubMedCentral
4.
Arai Y, Nakagawa S, Higuchi T, Inoue A, Honjo K, Inoue H, Ikoma K, Ueshima K, Ikeda T, Fujiwara H, Kudo T (2015) Comparative analysis of medial patellofemoral ligament length change pattern in patients with patellar dislocation using open-MRI. Knee Surg Sports Traumatol Arthrosc. doi:10.​1007/​s00167-015-3689-2 PubMedCentral
5.
Baldwin JL (2009) The anatomy of the medial patellofemoral ligament. Am J Sports Med 37(12):2355–2361CrossRefPubMed
6.
7.
Conlan T, Garth WP, Lemons JE (1993) Evaluation of the medial soft tissue restraints of the extensor mechanism of the knee. J Bone Joint Surg Am 75(5):682–693CrossRefPubMed
8.
Desio SM, Burks RT, Bachus KN (1998) Soft tissue restraints to lateral patellar translation in the human knee. Am J Sports Med 26(1):59–65CrossRefPubMed
9.
Enderlein D, Nielsen T, Christiansen SE, Faunø P, Lind M (2014) Clinical outcome after reconstruction of the medial patellofemoral ligament in patients with recurrent patella instability. Knee Surg Sports Traumatol Arthrosc 22(10):2458–2464CrossRefPubMed
10.
Gelaude F, Vander Sloten J, Lauwers B (2008) Accuracy assessment of CT-based outer surface femur meshes. Comput Aided Surg 13(4):188–199CrossRefPubMed
11.
Kang H, Cao J, Yu D, Zheng Z, Wang F (2013) Comparison of 2 different techniques for anatomic reconstruction of the medial patellofemoral ligament. Am J Sports Med 41(5):1013–1021CrossRefPubMed
12.
Mochizuki T, Nimura A, Tateishi T, Yamaguchi K, Muneta T, Akita K (2013) Anatomic study of the attachment of the medial patellofemoral ligament and its characteristic relationships to the vastus intermedius. Knee Surg Sports Traumatol Arthrosc 21(2):305–310CrossRefPubMed
13.
Nomura E, Inoue M, Osada N (2005) Anatomical analysis of the medial patellofemoral ligament of the knee, especially the femoral attachment. Knee Surg Sports Traumatol Arthrosc 13(7):510–515CrossRefPubMed
14.
Oliveira V, Souza V, Cury R, Camargo O, Avanzi O, Severino N, Fucs P (2014) Medial patellofemoral ligament anatomy: is it a predisposing factor for lateral patellar dislocation? Int Orthop 38(8):1633–1639CrossRefPubMedPubMedCentral
15.
Panagiotopoulos E, Strzelczyk P, Herrmann M, Scuderi G (2006) Cadaveric study on static medial patellar stabilizers: the dynamizing role of the vastus medialis obliquus on medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc 14(1):7–12CrossRefPubMed
16.
Philippot R, Chouteau J, WegrZyn J, Testa R, Fessy MH, Moyen B (2009) Medial patellofemoral ligament anatomy: implications for its surgical reconstruction. Knee Surg Sports Traumatol Arthrosc 17(5):475–479CrossRefPubMed
17.
Placella G, Tei MM, Sebastiani E, Criscenti G, Speziali A, Mazzola C, Georgoulis A, Cerulli G (2014) Shape and size of the medial patellofemoral ligament for the best surgical reconstruction: a human cadaveric study. Knee Surg Sports Traumatol Arthrosc 22(10):2327–2333CrossRefPubMed
18.
Reider B, Marshall JL, Koslin B, Ring B, Girgis FG (1981) The anterior aspect of the knee joint: an anatomical study. J Bone Joint Surg Am 63(3):351–356CrossRefPubMed
19.
Rood A, Hannink G, Lenting A, Groenen K, Koeter S, Verdonschot N, van Kampen A (2015) Patellofemoral pressure changes after static and dynamic medial patellofemoral ligament reconstructions. Am J Sports Med 43(10):2538–2544CrossRefPubMed
20.
Sallay PI, Poggi J, Speer KP et al (1996) Acute dislocation of the patella: a correlative pathoanatomic study. Am J Sports Med 24(1):52–60CrossRefPubMed
21.
Sanders TG, Morrison WB, Singleton BA, Miller MD, Cornum KG (2001) Medial patellofemoral ligament injury following acute transient dislocation of the patella: MR findings with surgical correction in 14 patients. J Comput Assist Tomogr 25(6):957–962CrossRefPubMed
22.
Schottle PB, Hensler D, Imhoff AB (2010) Anatomical double-bundle MPFL reconstruction with an aperture fixation. Knee Surg Sports Traumatol Arthrosc 18(2):147–151CrossRefPubMed
23.
Shah JN, Howard JS, Flanigan DC, Brophy RH, Carey JL, Lattermann C (2012) A systematic review of complications and failures associated with medial patellofemoral ligament reconstruction for recurrent patellar dislocation. Am J Sports Med 40(8):1916–1923CrossRefPubMedPubMedCentral
24.
Smirk C, Morris H (2003) The anatomy and reconstruction of the medial patellofemoral ligament. Knee 10(3):221–227CrossRefPubMed
25.
Steensen RN, Dopirak RM, McDonald WG 3rd (2004) The anatomy and isometry of the medial patellofemoral ligament: implications for reconstruction. Am J Sports Med 32(6):1509–1513CrossRefPubMed
26.
Tuxoe JI, Teir M, Nielsen PL (2002) The medial patellofemoral ligament: a dissection study. Knee Surg Sports Traumatol Arthrosc 10(3):138–140CrossRefPubMed
27.
Viste A, Chatelet F, Desmarchelier R, Fessy M-H (2014) Anatomical study of the medial patello-femoral ligament: landmarks for its surgical reconstruction. Surg Radiol Anat 36(8):733–739CrossRefPubMed
28.
Wang C, Ma L, Zhou J, Ji G, Wang H, Wang F, Wang J (2013) Double-bundle anatomical versus single-bundle isometric medial patellofemoral ligament reconstruction for patellar dislocation. Int Orthop 37(4):617–624CrossRefPubMedPubMedCentral
29.
Zheng L, Shi H, Feng Y, Sun BS, Ding HY, Zhang GY (2015) Injury patterns of medial patellofemoral ligament and correlation analysis with articular cartilage lesions of the lateral femoral condyle after acute lateral patellar dislocation in children and adolescents: an MRI evaluation. Injury 46(6):1137–1144CrossRefPubMed
Metadata
Title
Morphology of insertion sites on patellar side of medial patellofemoral ligament
Authors
Shuhei Kikuchi
Goro Tajima
Jun Yan
Youichi Kamei
Moritaka Maruyama
Atsushi Sugawara
Kotaro Fujino
Sanjuro Takeda
Minoru Doita
Publication date
01-08-2017
Publisher
Springer Berlin Heidelberg
Published in
Knee Surgery, Sports Traumatology, Arthroscopy / Issue 8/2017
Print ISSN: 0942-2056
Electronic ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-015-3973-1

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