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Cadaveric study of the secondary medial patellar restraints: patellotibial and patellomeniscal ligaments

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

Abstract

Purpose

To detail the anatomy of the medial patella stabilizers, medial patellotibial (MPTL), and medial patellomeniscal ligaments (MPML), focusing on the points of origin and insertion, length, thickness, width, and fibres orientation to study the frequency of anatomical variations and the anatomy of these ligaments, thereby improving surgical techniques.

Methods

Thirty dissected knees were analysed. A digital caliper was used to measure the length, thickness, and width, as well as the mid-point of the ligaments insertion and the distance from the MPTL insertion to the articular surface of the tibia. The angle of inclination of the ligaments was calculated in the coronal plane. The collected data were tabulated and statistically analysed.

Results

MPTL was present in 90 % as a visible thickening of the deep medial retinaculum and exhibiting only one anatomical variation. The MPML was absent in one of the dissected knees, and one anatomical variation was found. The tilt angle of the ligaments was very similar, with an average of 22.2° ± 7.6° for the MPTL and 24.2° ± 6.6° for the MPML.

Conclusion

The MPTL is a long visible structure of the deep layer of the medial retinaculum, but with a distinct origin and insertion. The MPML is thicker with an angular direction similar to MPTL. The presence of these ligaments in most of the specimens studied suggests that the real anatomical and biomechanical importance of these ligaments should be further investigated because they play a role in the patellar stability.

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Authors and Affiliations

  1. Knee Surgery Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa of São Paulo, Sao Paulo, SP, Brazil

    Camila Cohen Kaleka, Leandro Jun Aihara, Sebastião Ferreira de Medeiros, Victor Marques de Oliveira & Ricardo de Paula Leite Cury

  2. Trauma Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa of São Paulo, Sao Paulo, SP, Brazil

    Anderson Rodrigues

Authors
  1. Camila Cohen Kaleka
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  2. Leandro Jun Aihara
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  3. Anderson Rodrigues
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  4. Sebastião Ferreira de Medeiros
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  5. Victor Marques de Oliveira
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  6. Ricardo de Paula Leite Cury
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Corresponding author

Correspondence to Camila Cohen Kaleka.

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Conflict of interest

The authors above declare that they have no conflict of interest.

Funding

There is no funding source.

Ethical approval

The study protocol for obtaining, use and disposal of human tissue specimens received approval in 12/05/2012, permit number CAAE 08884712.8.0000.5479.

Informed consent

All patients provided written informed consent prior to participation.

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Kaleka, C.C., Aihara, L.J., Rodrigues, A. et al. Cadaveric study of the secondary medial patellar restraints: patellotibial and patellomeniscal ligaments. Knee Surg Sports Traumatol Arthrosc 25, 144–151 (2017). https://doi.org/10.1007/s00167-016-4322-8

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  • DOI: https://doi.org/10.1007/s00167-016-4322-8

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