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Anatomic study of the attachment of the medial patellofemoral ligament and its characteristic relationships to the vastus intermedius

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

Abstract

Purpose

The aim of this study was to investigate the attachment of the medial patellofemoral ligament (MPFL) using cadaver specimens and establish an anatomic basis for optimal MPFL reconstruction to achieve better patella stability.

Methods

Sixteen knees of eight cadavers were used in this study. The relationship of the MPFL with quadriceps muscles was investigated from outside after removal of the distal part of the vastus medialis and the rectus femoris and then evaluated from intra-articular side after release of lateral margin of the vastus lateralis muscle, patella and patella tendon.

Results

The proximal fibres of MPFL were mainly attached to the vastus intermedius tendon, without tight adhesion to the vastus medialis. The distal fibres of MPFL were interdigitated with the deep layer of the medial retinaculum that was attached to the medial margin of the patella tendon.

Conclusion

These findings imply that MPFL, which was directly attached to the vastus intermedius and patella and indirectly continued to the patella tendon, could keep pulling them medially as one unit and consequently make the patella move smoothly on the trochlea during whole movement of the knee. Clinically, dysfunction of both proximal and distal MPFL fibres should be considered in the diagnosis and treatment of patella instability after traumatic patella dislocation. MPFL reconstruction with both fibres has a possibility to lead ideal function of MPFL and better instability of the patella.

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Authors and Affiliations

  1. Section of Joint Reconstruction, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan

    Tomoyuki Mochizuki

  2. Unit of Clinical Anatomy, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan

    Akimoto Nimura, Kumiko Yamaguchi & Keiichi Akita

  3. Department of Orthopedic Surgery, Douai Memorial Hospital, 2-1-11, Yokoami, Sumida-ku, Tokyo, 130-8587, Japan

    Tomohiko Tateishi

  4. Section of Orthopedic Surgery, Graduate School, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan

    Takeshi Muneta

Authors
  1. Tomoyuki Mochizuki
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  2. Akimoto Nimura
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  3. Tomohiko Tateishi
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  4. Kumiko Yamaguchi
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  5. Takeshi Muneta
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  6. Keiichi Akita
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Correspondence to Keiichi Akita.

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Mochizuki, T., Nimura, A., Tateishi, T. et al. Anatomic study of the attachment of the medial patellofemoral ligament and its characteristic relationships to the vastus intermedius. Knee Surg Sports Traumatol Arthrosc 21, 305–310 (2013). https://doi.org/10.1007/s00167-012-1993-7

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  • DOI: https://doi.org/10.1007/s00167-012-1993-7

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