The medial patellofemoral complex

Abstract

Recent advances in our understanding of MPFC anatomy have found that there are fibers that insert onto the deep quadriceps tendon as well as the patella, thus earning the name "medial patellofemoral complex" to allow for the variability in its anatomy. In MPFC reconstruction, anatomic origin and insertion points and appropriate graft length are critical to prevent overconstraint of the patellofemoral joint. The MPFC is a crucial soft tissue checkrein to lateral patellar translation, and its repair or reconstruction results in good restoration of patellofemoral stability. As our understanding of MPFC anatomy evolves, further studies are needed to apply its relevance in kinematics and surgical applications to its role in maintaining patellar stability.

Double-Bundle Medial Patellofemoral Ligament Reconstruction With Allograft

“…Patellar dislocations typically occur when the femur internally rotates during pivoting movements. 1 , 4 In some cases, there may be a history of direct trauma to the medial aspect of the knee. 2 Most patellar dislocations occur in adolescents or young adults during athletic activity.…”

“…A double-bundle configuration is often used to anatomically approximate the MPFL insertion as it fans out on the proximal two-thirds of the patella. 4 …”

“… 21 This point represents the anatomic insertion of the medial patellofemoral ligament on the femur. 4 We use an Arthrex medial patellofemoral ligament template to precisely identify the Schöttle point. …”

“… 1 , 2 , 3 Although many factors contribute to patellofemoral instability, the MPFL is the most important restraint to lateral patellar translation. 4 In complete patellar dislocations, the MPFL is frequently torn at its insertion on the superior-medial patella. 5 However, midsubstance tears and injuries at the femoral attachment point are common as well.…”

Dynamic Evaluation of Patellofemoral Instability: A Clinical Reality or Just a Research Field? A Literature review

“…In more severe situations, PFI can lead to recurrent patellar dislocation, a disabling condition. The list of predisposing factors recognized for PFI is vast, including (but not limited to): patella alta, trochlear dysplasia, increased Q‐angle, muscular imbalance, increased femoral‐tibial torsion, genu valgus, hyperlaxity, and traumatic rupture of stabilizers such as the medial patellofemoral ligament.…”