Skip to main content
SpringerLink
Log in

Anatomical analysis of the medial patellofemoral ligament of the knee, especially the femoral attachment

  • Knee
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

The purpose of this study was to investigate the anatomical morphology and measurement of the medial patellofemoral ligament (MPFL), especially the femoral attachment. A total of 20 knee specimens were dissected and the total length, width, thickness, inclination, as well as the attachment points of the MPFL were measured. The MPFL was well-developed in seven knees, moderate in ten knees and wispy in three knees. Total length of the MPFL was 58.8 ± 4.7 mm. The width and thickness was 12.0 ± 3.1 mm and 0.44 ± 0.19 mm at the middle point. The long axis of the MPFL inclined at 15.9 ± 5.6° proximally. The center of the patellar attachment was located at 27 ± 10% from the upper end of the patella in the longitudinal patellar height. The femoral attachment was superoposterior to the medial femoral epicondyle and just distal to the adductor tubercle. The center of the anterior edge of the femoral attachment was 9.5 ± 1.8 mm proximally and 5.0 ± 1.7 mm posteriorly from the center of the medial femoral epicondyle. The femoral attachment was located at 61 ± 4% of anteroposterior length of the medial femoral condyle from the anterior edge.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6a, b

Similar content being viewed by others

References

  1. Ahmad CS, Stein BE, Matuz D, Henry JH (2000) Immediate surgical repair of the medial patellar stabilizers for acute patellar dislocation. Am J Sports Med 28:804–810

    CAS  PubMed  Google Scholar 

  2. Aichroth PM, Al-Duri Z (1992) Dislocation and subluxation of the patella. An overview. In: Aichroth PM, Al-Duri Z (eds) Knee surgery. Martin Dunitz Ltd, Deutscher Ärzte-Verlag Köln, pp 354–379

    Google Scholar 

  3. Amis AA, Firer P, Mountney J, Senavongse W, Thomas NP (2003) Anatomy and biomechanics of the medial patellofemoral ligament. Knee 10:215–220

    Article  CAS  PubMed  Google Scholar 

  4. Arendt EA, Fithian DC, Cohen E (2002) Current concepts of lateral patella dislocation. Clin Sports Med 21:499–519

    Article  PubMed  Google Scholar 

  5. Avikainen VJ, Nikku RK, Seppannen-Lehmenen TK (1993) Adductor magnus tenodesis for patellar dislocation: Technique and preliminary results. Clin Orthop 297:12–16

    PubMed  Google Scholar 

  6. Burks RT, Desio SM, Bachus KN, Tyson L, Springer K (1998) Biomechanical evaluation of lateral patellar dislocation. Am J Knee Surg 11:24–31

    CAS  PubMed  Google Scholar 

  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 75:682–693

    CAS  PubMed  Google Scholar 

  8. Davis DK, Fithian DC (2002) Techniques of medial retinacular repair and reconstruction. Clin Orthop 402:38–52

    PubMed  Google Scholar 

  9. Desio DS, Burk RT, Bachus KN (1998) Soft tissue restraint to lateral patellar translation in the human knee. Am J Sports Med 26:59–65

    CAS  PubMed  Google Scholar 

  10. Ellera Gomes JL (1993) Medial patellofemoral ligament reconstruction for recurrent dislocation of the patella: a preliminary report. Arthroscopy 8:335–340

    Google Scholar 

  11. Feller JA, Feagin JA, Garrett WE (1993) The medial patellofemoral ligament revisited: an anatomical study. Knee Surg Sports Traumatol Arthrosc 1:184–186

    Article  CAS  PubMed  Google Scholar 

  12. Fulkerson JP, Hungerford DS (1990) Disorders of the patellofemoral Joint, 2nd edn. Williams and Wilkins, Baltimore

    Google Scholar 

  13. Fithian DC, Nomura E, Arendt E (2001) Anatomy of patellar dislocation. Oper Tech Sports Med 9:102–111

    Google Scholar 

  14. Hautamaa PV, Fithian DC, Kaufmann KR, Daniel DM, Pohlmeyer AM (1998) Medial soft tissue restraints in lateral patellar instability and repair. Clin Orthop 349:174–182

    PubMed  Google Scholar 

  15. Hughston JC, Walsh WM, Puddu G (1984) Patellar subluxation and dislocation. Saunders, Philadelphia

    Google Scholar 

  16. Kaplan EB (1957) Factors responsible for the stability of the knee joint. Bull Hosp Joint Dis 18:51–59

    CAS  PubMed  Google Scholar 

  17. Lang J, Wachsmuth W (1979) Praktische Anatomie; Bein und Statik (Japanese version). Springer, Berlin Heidelberg New York

    Google Scholar 

  18. Nomura E, Fujikawa K, Takeda T, Matsumoto H (1992) Anatomical study of the medial patellofemoral ligament (in Japanese). Bessatsu Seikeigeka 22:2–5

    Google Scholar 

  19. Nomura E, Fujikawa K, Takeda T, Matsumoto H (1993) Functional anatomy of the medial patellofemoral ligament (in Japanese). Rinsho Seikei Geka 28:5–10

    Google Scholar 

  20. Nomura E (1999) Classification of lesions of the medial patello-femoral ligament in patellar dislocation. Int Orthop 23:260–263

    Article  CAS  PubMed  Google Scholar 

  21. Nomura E, Horiuchi Y, Kihara M (2000) Medial patellofemoral ligament restraint in lateral patellar translation and reconstruction. Knee 7:121–127

    Article  PubMed  Google Scholar 

  22. Nomura E, Horiuchi Y, Kihara M (2000) A mid-term follow-up of medial patellofemoral ligament reconstruction using an artificial ligament for recurrent patellar dislocation. Knee 7:211–215

    Article  PubMed  Google Scholar 

  23. Nomura E, Horiuchi Y, Inoue M (2002) Correlation of MR imaging findings and open exploration of medial patellofemoral ligament injuries in acute patellar dislocation. Knee 9:139–143

    Article  CAS  PubMed  Google Scholar 

  24. Nomura E, Inoue M (2004) Injured medial patellofemoral ligament in acute patellar dislocation. J Knee Surg 17:40–46

    PubMed  Google Scholar 

  25. 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 63:351–356

    CAS  PubMed  Google Scholar 

  26. Sallay PI, Poggi J, Speer KP, Garrett WE (1996) Acute dislocation of the patella: a correlative pathoanatomical study. Am J Sports Med 24:52–60

    CAS  PubMed  Google Scholar 

  27. Sandmeier RH, Burks RT, Bachus KN, Billings A (2000) The effect of reconstruction of the medial patellofemoral ligament on patellar tracking. Am J Sports Med 28:345–349

    CAS  PubMed  Google Scholar 

  28. Smirk C, Morris H (2003) The anatomy and reconstruction of the medial patellofemoral ligament. Knee 10:221–227

    Article  PubMed  Google Scholar 

  29. Spritzer CE, Courneya DL, Burk DL Jr, Garrett WE, Strong JA (1997) Medial retinacular complex injury in acute patellar dislocation: MR findings and surgical implications. Am J Roentgenol 168:117–122

    CAS  Google Scholar 

  30. Tuxoe JI, Teir M, Winge S, Nielsen PL (2002) The medial patellofemoral ligament: a dissection study. Knee Surg Sports Traumatol Arthrosc 10:138–140

    Article  PubMed  Google Scholar 

  31. Warren LF, Marshall J (1979) The supporting structures and layers on the medial side of the knee: an anatomical study. J Bone Joint Surg Am 61:56–62

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Kawasaki Municipal Hospital, 12-1, Shinkawadori, Kawasaki-ku, Kawasaki, 210-0013, Japan

    Eiki Nomura & Natsuya Osada

  2. Department of Orthopaedic Surgery, Isehara-kyodo Hospital, Sakuradai, Isehara, Japan

    Motoyasu Inoue

Authors
  1. Eiki Nomura
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Motoyasu Inoue
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Natsuya Osada
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Eiki Nomura.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nomura, E., Inoue, M. & Osada, N. Anatomical analysis of the medial patellofemoral ligament of the knee, especially the femoral attachment. Knee Surg Sports Traumatol Arthrosc 13, 510–515 (2005). https://doi.org/10.1007/s00167-004-0607-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-004-0607-4

Keywords

Search

Navigation