Skip to main content
Log in

Medial patellofemoral ligament anatomy: implications for its surgical reconstruction

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

Abstract

The purpose of the present study, based on 23 cadaveric knees, was to perform a detailed anatomical analysis of the medial patellofemoral ligament (MPFL), especially its femoral attachment, its relationships with the vastus medialis obliquus (VMO) and the medial collateral ligament, with the objective of improving its surgical reconstruction. The femoral insertion of the MPFL was defined using an orthonormal frame centered on the middle of the femoral MPFL insertion. The whole measurements were taken using a millimetric compass with a precision of ±1 mm. The MPFL was always observed, its length was 57.7 ± 5.8 mm, the junction between the VMO and the MPFL always present measured 25.7 ± 6.0 mm. When it comes to MPFL reconstruction, the key point is its positioning in the femoral insertion because it is this insertion that is going to restore isometry. By using the orthonormal frame it has to be positioned 10 mm behind the medial epicondyle and 10 mm distal to the adductor tubercle.

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

Access this article

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.

Fig. 1
Fig. 2

Similar content being viewed by others

References

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

    Article  PubMed  CAS  Google Scholar 

  2. Andrish J (2004) The biomechanics of patellofemoral stability. J Knee Surg 17:35–39

    PubMed  Google Scholar 

  3. Bicos J, Fulkerson JP, Amis A (2007) Current concepts review: the medial patellofemoral ligament. Am J Sports Med 35:484–492

    Article  PubMed  Google Scholar 

  4. Conlan T, Garth WP Jr, 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

    PubMed  CAS  Google Scholar 

  5. Desio SM, Burks RT, Bachus KN (1998) Soft tissue restraints to lateral patellar translation in the human knee. Am J Sports Med 26:59–65

    PubMed  CAS  Google Scholar 

  6. Elias JJ, Cosgarea AJ (2006) Technical errors during medial patellofemoral ligament reconstruction could overload medial patellofemoral cartilage: a computational analysis. Am J Sports Med 34:1478–1485

    Article  PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  8. Fithian DC, Paxton EW, Stone ML, Silva P, Davis DK, Elias DA et al (2004) Epidemiology and natural history of acute patellar dislocation. Am J Sports Med 32:1114–1121

    Article  PubMed  Google Scholar 

  9. Froelke BM, Elias JJ, Cosgarea AJ (2006) Surgical options for treating injuries to the medial patellofemoral ligament. J Knee Surg 19:296–306

    PubMed  Google Scholar 

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

  11. 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 

  12. 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 13:510–515

    Article  PubMed  Google Scholar 

  13. 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 14:7–12

    Article  PubMed  Google Scholar 

  14. Reider B, Marshall JL, Koslin B, Ring B, Girgis FG (1981) The anterior aspect of the knee joint. J Bone Joint Surg Am 63:351–356

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  16. Steensen RN, Dopirak RM, McDonald WG 3rd (2004) The anatomy and isometry of the medial patellofemoral ligament: implications for reconstruction. Am J Sports Med 32:1509–1513

    Article  PubMed  Google Scholar 

  17. 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 

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

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Rémi Philippot.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Philippot, R., Chouteau, J., Wegrzyn, J. et al. Medial patellofemoral ligament anatomy: implications for its surgical reconstruction. Knee Surg Sports Traumatol Arthrosc 17, 475–479 (2009). https://doi.org/10.1007/s00167-009-0722-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-009-0722-3

Keywords

Navigation