Metric Measurements and Attachment Levels of the Medial Patellofemoral Ligament: An Anatomical Study in Cadavers

Abstract

Aragão JA, Reis FP, Vasconcelos DP, Feitosa VLC, Nunes MAP. Metric measurements and attachment levels of the medial patellofemoral ligament: an anatomical study in cadavers. Clinics. 2008;63:541-4. OBJECTIVE:To determine the metric measurements and to verify the attachment levels of the medial patellofemoral ligament in human cadavers. METHODS: Seventeen knees (eight right and nine left knees) from 10 cadavers (nine male and one female) were dissected and stored in a 10% formaldehyde solution. All of the knees were whole and did not show any macroscopic signs of injuries. RESULTS: The medial patellofemoral ligament was present in 88% of the knees studied, localized transversally between the medial femoral epicondyle and the medial margin of the patella. Its dimensions were quite variable, even between the knees of the same individual. The width of the patellar insertion ranged from 16 to 38.8 mm, with a mean of 27.90 mm, and its mean length was 55.67 mm. The margins of the ligament were concave or rectilinear. At the upper margin, the concave form predominated and was better characterized, while at the lower margin, the rectilinear form predominated. CONCLUSIONS: The medial patellofemoral ligament is a very distinct structure with variable anatomical aspects and is always located in a plane inferior to the vastus medialis obliquus muscle.

An anatomical study of the origin, structure and insertion of the medial patellofemoral ligament

“…According to Aragao et al [2], in 40% of specimens MPFL was attached to more than 2/3 of the whole medial margin of the patella, and in 27% was attached to the whole medial margin of the patella. Robert et al [3]demonstrated that the lateral width of the MPFL origin from the patella was 38.8% of the entire patellar height.…”

“…The anatomical study by Tuxoe et al [12]found that it was at the femoral attachment point close to the medial collateral ligament distal from the adductor tubercle. Nomura et al [13], Panagiotopoulos et al [14], and Aragao et al [2]believed the normal MPFL started between the femoral medial epicondyle and adductor tubercle. The femoral tunnel should be centered 2.5 mm distal to the adductor tubercle.…”

“…The literature contains varying descriptions of the anatomy of the MPFL [2][3][4][5][6][7][8][9][10][11][12][13][14]. In summary the MPFL is located medially on the knee between the superficial fascia and the joint capsule.…”

“…The origin is from the medial patella and vastus medialis tendon. The size of the origin varies widely [2][3][4][5]. The MPFL itself has been described as transverse fibrous tissue [15].…”

Estudo da articulação patelofemoral por ressonância magnética: a variação da morfologia do ligamento patelofemoral medial

“…ligament, the medial retinaculum and even the lateral retinaculum (1,2,(6)(7)(8) . Among these structures, it has been accepted that the MPFL is the primary restrictor against lateral patellar displacement (1,6,(7)(8)(9) . It is recognized as the most important structure in restricting against lateral displacement or subluxation of the patella, and tearing of the MPFL is frequently cited as the essential lesion in lateral displacement of the patella.…”