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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Purpose To describe the femoral insertion of the ACL using the posterior proximal cartilage of the lateral femoral condyle as the anatomical reference. Methods Twenty knees were dissected. The X-axis (deep-shallow) and Y-axis (high-low) were determined using the femoral diaphysis and the proximal cartilage of the lateral femoral condyle (point C) as a reference, which were easily identiied by direct visualization through the anteromedial portal. The distances to the center of the anteromedial and posterolateral bands and to the center of the ACL were measured. ResultsThe mean distances were 7.2 mm (SD: 0.7) between the center of the anteromedial bundle and the Y-axis (AM-Y), 9 mm (SD: 1.1) between the center of the ACL and the Y-axis (M-Y), and 12.7 mm (SD: 0.9) between the center of the posterolateral bundle and the Y-axis (PL-Y). Regarding the distance (from point C to the distal cartilage along the X-axis), the center of the anteromedial bundle (AM) was 35% (SD: 4.9%), the center of the posterolateral bundle was 62% (SD: 3.7%), and the center of the ACL (M) was 44% (SD: 7%) of the CD distance on average. Conclusion Given the similarity among the specimens in terms of the height of the ACL on the Y-axis in relation to the proximal posterior cartilage of the femoral lateral condyle (point C), this point can be used as an arthroscopic intraoperative parameter to deine the position of the femoral tunnel in ACL reconstruction for single-or double-bundle techniques.

A ruptura simultânea do tendão quadricipital e do tendão patelar contralateral representa uma associação extremamente rara, e poucos casos foram reportados na literatura. Doenças sistêmicas predispõe a ruptura tendinosa espontâ- nea, como insuficiência renal crônica, hiperparatireoidismo, artrite reumatoide, gota e lúpus eritematoso sistêmico. Nós reportamos o caso de uma mulher de 40 anos, com insuficiência renal crônica dialítica e hiperparatireoidismo secundário, que sofreu uma ruptura espontânea e simultânea do tendão patelar de um joelho e do tendão quadricipital do outro. O reparo da lesão dos tendões patelar e quadricipital foi realizado através de sutura não absorvível com pontos transósseos, e o reparo do tendão patelar foi complementado com a confecção de um dispositivo de proteção dinâmica. Boa recuperação funcional foi obtida em ambos os joelhos. Este caso enfatiza a importância do hiperparatireoidismo secundário na etiologia das rupturas tendinosas, em pacientes com insuficiência renal crônica.