Skip to main content
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 7/2005

01.10.2005 | Knee

Anatomical analysis of the medial patellofemoral ligament of the knee, especially the femoral attachment

verfasst von: Eiki Nomura, Motoyasu Inoue, Natsuya Osada

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 7/2005

Einloggen, um Zugang zu erhalten

Abstract

The purpose of this study was to investigate the anatomical morphology and measurement of the medial patellofemoral ligament (MPFL), especially the femoral attachment. A total of 20 knee specimens were dissected and the total length, width, thickness, inclination, as well as the attachment points of the MPFL were measured. The MPFL was well-developed in seven knees, moderate in ten knees and wispy in three knees. Total length of the MPFL was 58.8 ± 4.7 mm. The width and thickness was 12.0 ± 3.1 mm and 0.44 ± 0.19 mm at the middle point. The long axis of the MPFL inclined at 15.9 ± 5.6° proximally. The center of the patellar attachment was located at 27 ± 10% from the upper end of the patella in the longitudinal patellar height. The femoral attachment was superoposterior to the medial femoral epicondyle and just distal to the adductor tubercle. The center of the anterior edge of the femoral attachment was 9.5 ± 1.8 mm proximally and 5.0 ± 1.7 mm posteriorly from the center of the medial femoral epicondyle. The femoral attachment was located at 61 ± 4% of anteroposterior length of the medial femoral condyle from the anterior edge.
Literatur
1.
Zurück zum Zitat Ahmad CS, Stein BE, Matuz D, Henry JH (2000) Immediate surgical repair of the medial patellar stabilizers for acute patellar dislocation. Am J Sports Med 28:804–810PubMed Ahmad CS, Stein BE, Matuz D, Henry JH (2000) Immediate surgical repair of the medial patellar stabilizers for acute patellar dislocation. Am J Sports Med 28:804–810PubMed
2.
Zurück zum Zitat Aichroth PM, Al-Duri Z (1992) Dislocation and subluxation of the patella. An overview. In: Aichroth PM, Al-Duri Z (eds) Knee surgery. Martin Dunitz Ltd, Deutscher Ärzte-Verlag Köln, pp 354–379 Aichroth PM, Al-Duri Z (1992) Dislocation and subluxation of the patella. An overview. In: Aichroth PM, Al-Duri Z (eds) Knee surgery. Martin Dunitz Ltd, Deutscher Ärzte-Verlag Köln, pp 354–379
3.
Zurück zum Zitat Amis AA, Firer P, Mountney J, Senavongse W, Thomas NP (2003) Anatomy and biomechanics of the medial patellofemoral ligament. Knee 10:215–220CrossRefPubMed Amis AA, Firer P, Mountney J, Senavongse W, Thomas NP (2003) Anatomy and biomechanics of the medial patellofemoral ligament. Knee 10:215–220CrossRefPubMed
4.
Zurück zum Zitat Arendt EA, Fithian DC, Cohen E (2002) Current concepts of lateral patella dislocation. Clin Sports Med 21:499–519CrossRefPubMed Arendt EA, Fithian DC, Cohen E (2002) Current concepts of lateral patella dislocation. Clin Sports Med 21:499–519CrossRefPubMed
5.
Zurück zum Zitat Avikainen VJ, Nikku RK, Seppannen-Lehmenen TK (1993) Adductor magnus tenodesis for patellar dislocation: Technique and preliminary results. Clin Orthop 297:12–16PubMed Avikainen VJ, Nikku RK, Seppannen-Lehmenen TK (1993) Adductor magnus tenodesis for patellar dislocation: Technique and preliminary results. Clin Orthop 297:12–16PubMed
6.
Zurück zum Zitat Burks RT, Desio SM, Bachus KN, Tyson L, Springer K (1998) Biomechanical evaluation of lateral patellar dislocation. Am J Knee Surg 11:24–31PubMed Burks RT, Desio SM, Bachus KN, Tyson L, Springer K (1998) Biomechanical evaluation of lateral patellar dislocation. Am J Knee Surg 11:24–31PubMed
7.
Zurück zum Zitat Conlan T, Garth WP, Lemons JE (1993) Evaluation of the medial soft-tissue restraints of the extensor mechanism of the knee. J Bone Joint Surg Am 75:682–693PubMed Conlan T, Garth WP, Lemons JE (1993) Evaluation of the medial soft-tissue restraints of the extensor mechanism of the knee. J Bone Joint Surg Am 75:682–693PubMed
8.
Zurück zum Zitat Davis DK, Fithian DC (2002) Techniques of medial retinacular repair and reconstruction. Clin Orthop 402:38–52PubMed Davis DK, Fithian DC (2002) Techniques of medial retinacular repair and reconstruction. Clin Orthop 402:38–52PubMed
9.
Zurück zum Zitat Desio DS, Burk RT, Bachus KN (1998) Soft tissue restraint to lateral patellar translation in the human knee. Am J Sports Med 26:59–65PubMed Desio DS, Burk RT, Bachus KN (1998) Soft tissue restraint to lateral patellar translation in the human knee. Am J Sports Med 26:59–65PubMed
10.
Zurück zum Zitat Ellera Gomes JL (1993) Medial patellofemoral ligament reconstruction for recurrent dislocation of the patella: a preliminary report. Arthroscopy 8:335–340 Ellera Gomes JL (1993) Medial patellofemoral ligament reconstruction for recurrent dislocation of the patella: a preliminary report. Arthroscopy 8:335–340
11.
Zurück zum Zitat Feller JA, Feagin JA, Garrett WE (1993) The medial patellofemoral ligament revisited: an anatomical study. Knee Surg Sports Traumatol Arthrosc 1:184–186CrossRefPubMed Feller JA, Feagin JA, Garrett WE (1993) The medial patellofemoral ligament revisited: an anatomical study. Knee Surg Sports Traumatol Arthrosc 1:184–186CrossRefPubMed
12.
Zurück zum Zitat Fulkerson JP, Hungerford DS (1990) Disorders of the patellofemoral Joint, 2nd edn. Williams and Wilkins, Baltimore Fulkerson JP, Hungerford DS (1990) Disorders of the patellofemoral Joint, 2nd edn. Williams and Wilkins, Baltimore
13.
Zurück zum Zitat Fithian DC, Nomura E, Arendt E (2001) Anatomy of patellar dislocation. Oper Tech Sports Med 9:102–111 Fithian DC, Nomura E, Arendt E (2001) Anatomy of patellar dislocation. Oper Tech Sports Med 9:102–111
14.
Zurück zum Zitat Hautamaa PV, Fithian DC, Kaufmann KR, Daniel DM, Pohlmeyer AM (1998) Medial soft tissue restraints in lateral patellar instability and repair. Clin Orthop 349:174–182PubMed Hautamaa PV, Fithian DC, Kaufmann KR, Daniel DM, Pohlmeyer AM (1998) Medial soft tissue restraints in lateral patellar instability and repair. Clin Orthop 349:174–182PubMed
15.
Zurück zum Zitat Hughston JC, Walsh WM, Puddu G (1984) Patellar subluxation and dislocation. Saunders, Philadelphia Hughston JC, Walsh WM, Puddu G (1984) Patellar subluxation and dislocation. Saunders, Philadelphia
16.
Zurück zum Zitat Kaplan EB (1957) Factors responsible for the stability of the knee joint. Bull Hosp Joint Dis 18:51–59PubMed Kaplan EB (1957) Factors responsible for the stability of the knee joint. Bull Hosp Joint Dis 18:51–59PubMed
17.
Zurück zum Zitat Lang J, Wachsmuth W (1979) Praktische Anatomie; Bein und Statik (Japanese version). Springer, Berlin Heidelberg New York Lang J, Wachsmuth W (1979) Praktische Anatomie; Bein und Statik (Japanese version). Springer, Berlin Heidelberg New York
18.
Zurück zum Zitat Nomura E, Fujikawa K, Takeda T, Matsumoto H (1992) Anatomical study of the medial patellofemoral ligament (in Japanese). Bessatsu Seikeigeka 22:2–5 Nomura E, Fujikawa K, Takeda T, Matsumoto H (1992) Anatomical study of the medial patellofemoral ligament (in Japanese). Bessatsu Seikeigeka 22:2–5
19.
Zurück zum Zitat Nomura E, Fujikawa K, Takeda T, Matsumoto H (1993) Functional anatomy of the medial patellofemoral ligament (in Japanese). Rinsho Seikei Geka 28:5–10 Nomura E, Fujikawa K, Takeda T, Matsumoto H (1993) Functional anatomy of the medial patellofemoral ligament (in Japanese). Rinsho Seikei Geka 28:5–10
20.
Zurück zum Zitat Nomura E (1999) Classification of lesions of the medial patello-femoral ligament in patellar dislocation. Int Orthop 23:260–263CrossRefPubMed Nomura E (1999) Classification of lesions of the medial patello-femoral ligament in patellar dislocation. Int Orthop 23:260–263CrossRefPubMed
21.
Zurück zum Zitat Nomura E, Horiuchi Y, Kihara M (2000) Medial patellofemoral ligament restraint in lateral patellar translation and reconstruction. Knee 7:121–127CrossRefPubMed Nomura E, Horiuchi Y, Kihara M (2000) Medial patellofemoral ligament restraint in lateral patellar translation and reconstruction. Knee 7:121–127CrossRefPubMed
22.
Zurück zum Zitat Nomura E, Horiuchi Y, Kihara M (2000) A mid-term follow-up of medial patellofemoral ligament reconstruction using an artificial ligament for recurrent patellar dislocation. Knee 7:211–215CrossRefPubMed Nomura E, Horiuchi Y, Kihara M (2000) A mid-term follow-up of medial patellofemoral ligament reconstruction using an artificial ligament for recurrent patellar dislocation. Knee 7:211–215CrossRefPubMed
23.
Zurück zum Zitat Nomura E, Horiuchi Y, Inoue M (2002) Correlation of MR imaging findings and open exploration of medial patellofemoral ligament injuries in acute patellar dislocation. Knee 9:139–143CrossRefPubMed Nomura E, Horiuchi Y, Inoue M (2002) Correlation of MR imaging findings and open exploration of medial patellofemoral ligament injuries in acute patellar dislocation. Knee 9:139–143CrossRefPubMed
24.
Zurück zum Zitat Nomura E, Inoue M (2004) Injured medial patellofemoral ligament in acute patellar dislocation. J Knee Surg 17:40–46PubMed Nomura E, Inoue M (2004) Injured medial patellofemoral ligament in acute patellar dislocation. J Knee Surg 17:40–46PubMed
25.
Zurück zum Zitat Reider B, Marshall JL, Koslin B, Ring B, Girgis FG (1981) The anterior aspect of the knee joint: an anatomical study. J Bone Joint Surg Am 63:351–356PubMed Reider B, Marshall JL, Koslin B, Ring B, Girgis FG (1981) The anterior aspect of the knee joint: an anatomical study. J Bone Joint Surg Am 63:351–356PubMed
26.
Zurück zum Zitat Sallay PI, Poggi J, Speer KP, Garrett WE (1996) Acute dislocation of the patella: a correlative pathoanatomical study. Am J Sports Med 24:52–60PubMed Sallay PI, Poggi J, Speer KP, Garrett WE (1996) Acute dislocation of the patella: a correlative pathoanatomical study. Am J Sports Med 24:52–60PubMed
27.
Zurück zum Zitat Sandmeier RH, Burks RT, Bachus KN, Billings A (2000) The effect of reconstruction of the medial patellofemoral ligament on patellar tracking. Am J Sports Med 28:345–349PubMed Sandmeier RH, Burks RT, Bachus KN, Billings A (2000) The effect of reconstruction of the medial patellofemoral ligament on patellar tracking. Am J Sports Med 28:345–349PubMed
28.
Zurück zum Zitat Smirk C, Morris H (2003) The anatomy and reconstruction of the medial patellofemoral ligament. Knee 10:221–227CrossRefPubMed Smirk C, Morris H (2003) The anatomy and reconstruction of the medial patellofemoral ligament. Knee 10:221–227CrossRefPubMed
29.
Zurück zum Zitat Spritzer CE, Courneya DL, Burk DL Jr, Garrett WE, Strong JA (1997) Medial retinacular complex injury in acute patellar dislocation: MR findings and surgical implications. Am J Roentgenol 168:117–122 Spritzer CE, Courneya DL, Burk DL Jr, Garrett WE, Strong JA (1997) Medial retinacular complex injury in acute patellar dislocation: MR findings and surgical implications. Am J Roentgenol 168:117–122
30.
Zurück zum Zitat Tuxoe JI, Teir M, Winge S, Nielsen PL (2002) The medial patellofemoral ligament: a dissection study. Knee Surg Sports Traumatol Arthrosc 10:138–140CrossRefPubMed Tuxoe JI, Teir M, Winge S, Nielsen PL (2002) The medial patellofemoral ligament: a dissection study. Knee Surg Sports Traumatol Arthrosc 10:138–140CrossRefPubMed
31.
Zurück zum Zitat Warren LF, Marshall J (1979) The supporting structures and layers on the medial side of the knee: an anatomical study. J Bone Joint Surg Am 61:56–62PubMed Warren LF, Marshall J (1979) The supporting structures and layers on the medial side of the knee: an anatomical study. J Bone Joint Surg Am 61:56–62PubMed
Metadaten
Titel
Anatomical analysis of the medial patellofemoral ligament of the knee, especially the femoral attachment
verfasst von
Eiki Nomura
Motoyasu Inoue
Natsuya Osada
Publikationsdatum
01.10.2005
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 7/2005
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-004-0607-4

Weitere Artikel der Ausgabe 7/2005

Knee Surgery, Sports Traumatology, Arthroscopy 7/2005 Zur Ausgabe

Announcements

October 2005

Arthropedia

Grundlagenwissen der Arthroskopie und Gelenkchirurgie. Erweitert durch Fallbeispiele, Videos und Abbildungen. 
» Jetzt entdecken

Knie-TEP: Kein Vorteil durch antibiotikahaltigen Knochenzement

29.05.2024 Periprothetische Infektionen Nachrichten

Zur Zementierung einer Knie-TEP wird in Deutschland zu über 98% Knochenzement verwendet, der mit einem Antibiotikum beladen ist. Ob er wirklich besser ist als Zement ohne Antibiotikum, kann laut Registerdaten bezweifelt werden.

Häusliche Gewalt in der orthopädischen Notaufnahme oft nicht erkannt

28.05.2024 Häusliche Gewalt Nachrichten

In der Notaufnahme wird die Chance, Opfer von häuslicher Gewalt zu identifizieren, von Orthopäden und Orthopädinnen offenbar zu wenig genutzt. Darauf deuten die Ergebnisse einer Fragebogenstudie an der Sahlgrenska-Universität in Schweden hin.

Fehlerkultur in der Medizin – Offenheit zählt!

28.05.2024 Fehlerkultur Podcast

Darüber reden und aus Fehlern lernen, sollte das Motto in der Medizin lauten. Und zwar nicht nur im Sinne der Patientensicherheit. Eine negative Fehlerkultur kann auch die Behandelnden ernsthaft krank machen, warnt Prof. Dr. Reinhard Strametz. Ein Plädoyer und ein Leitfaden für den offenen Umgang mit kritischen Ereignissen in Medizin und Pflege.

Mehr Frauen im OP – weniger postoperative Komplikationen

21.05.2024 Allgemeine Chirurgie Nachrichten

Ein Frauenanteil von mindestens einem Drittel im ärztlichen Op.-Team war in einer großen retrospektiven Studie aus Kanada mit einer signifikanten Reduktion der postoperativen Morbidität assoziiert.

Update Orthopädie und Unfallchirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.