Shape and size of the medial patellofemoral ligament for the best surgical reconstruction: a human cadaveric study

Abstract

The MPFL is a distinct structure that goes from patella to femur with a sail-like shape; its patellar insertion, that mostly occur via an aponeurosis tissue with VMO and VI, is at the proximal third of the patella but it may extend in some cases to the medial third patella or to the quadriceps tendon, or very rarely to the distal third of the patella. In the femoral side, the MPFL is inserted in its own site, in most cases distinct both from epicondyle and adductor tubercle, located on average at a 9.5 mm distance distally and anteriorly in respect to the adductor tubercle. Its lower margin was difficult to define. Given the importance of this structure, it must be reconstructed as anatomically as possible in its insertion and in its shape. Many attempts have been made to make functional reconstructions with less than excellent results.

Biomechanical evaluation of medial patello-femoral ligament reconstruction: comparison between a double-bundle converging tunnels technique versus a single-bundle technique

“…Previous studies have demonstrated that this structure is always injured after lateral patellar dislocation [10,12,13] thus, MPFL reconstruction is commonly performed to restore the patello-femoral stability. However, many technical errors during MPFL reconstruction could overload and alter the patello-femoral joint [14,15].…”

Impact of the patella height on the strain pattern of the medial patellofemoral ligament after reconstruction: a computer model-based study

“…The anatomy of the MPFL has been described in recent studies [2,11,24], and surgical insertion points have been defined [26]. Different surgical techniques for MPFL reconstruction exist, yet they all aim for anatomic insertion points [6,15,18].…”

Medial Patellofemoral Ligament Reconstruction Using Dual Patella Docking Technique

“…29 Its insertion on the patella is broad, attaching along the proximal twothirds in a fan-shaped manner. 29,36 Kang et al 37 described 2 functional bundles of the MPFL. Use of a 2-limb graft technique, as we describe, as opposed to singleegraft limb patellar insertion allows for more accurate re-creation of these bundles and insertion on the MPFL.…”