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A polygon-shaped complex appearance of medial patellofemoral ligament with dynamic functional insertion based on an outside-in and inside-out dissection technique

  • Yunshen Ge
  • Shiyi Chen
  • Tomohiro Kato
  • Urszula Zdanowicz
  • Robert Smigielski
Knee

Abstract

Purpose

To describe the unclarified characteristics of medial patellofemoral ligament and its relation to neighboring structures.

Methods

Sixteen fresh-frozen human knees were dissected in using outside-in and inside-out combined technique. The patellar side attachment was observed from the inside view and femoral side from outside view.

Results

The medial patellofemoral ligament was described a complex and multiconnected structure. The femoral side included the upper and lower portion, of which the upper portion attached on the femur with mean width 7.5 ± 1.1 mm and its superficial fibers extended to the adductor magnus tendon and the medial gastrocnemius tendon, and of which the lower portion appeared a right-triangle connected to the MCL without bony attachment. From inside view, the patellar attachment consisted of the bony and non-bony parts. The width of bony attachment was measured mean 16.3 ± 3.8 mm, and the non-bony attachment was found attached on the vastus intermedius tendon with mean width 21.7 ± 4.8 mm. The average thickness was 0.4 ± 0.1 mm and the length were inside assessed mean 67.9 ± 6.1 mm.

Conclusion

The medial patellofemoral ligament which dissected a complicated structure with bony and non-bony attachment and multi-connected to neighboring structures on both patella and femur side appears as a polygon-shaped complex structure.

Keywords

Medial patellofemoral ligament Anatomy Medial patellofemoral complex Medial gastrocnemius tendon Polygon-shaped complex 

Notes

Acknowledgements

The authors thank Robert Smigielski and all the staffs from Carolina Medical Center and CEMED Lab for their support and help through the study. The specimens were supplied by the Carolina Medical Center and CEMED Lab (Warsaw, Poland). Many thanks to Mr. Maciej S’miarowski (maciej.smiarowski@gmail.com) for his taking all photographs and very nice job.

Funding

There was no outside funding or grants received that assisted in this study.

Compliance with ethical standards

Conflict of interest

The authors declare no competing financial interest.

Ethical approval

This study has been performed in accordance with the ethical standards concerning investigations on human cadavers in Poland.

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Copyright information

© European Society of Sports Traumatology, Knee Surgery, Arthroscopy (ESSKA) 2018

Authors and Affiliations

  1. 1.Department of Sports MedicineHuashan HospitalShanghaiPeople’s Republic of China
  2. 2.Department of Orthopaedic SurgeryHiroshima UniversityHiroshimaJapan
  3. 3.Orthopaedic and Sports Traumatology DepartmentCarolina Medical CenterWarsawPoland

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