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Knee Surgery, Sports Traumatology, Arthroscopy
Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy 4/2015

01.04.2015 | Knee

Morphology of the femoral insertion site of the medial patellofemoral ligament

verfasst von: Kotaro Fujino, Goro Tajima, Jun Yan, Youichi Kamei, Moritaka Maruyama, Sanjuro Takeda, Shuhei Kikuchi, Tadashi Shimamura

Erschienen in: Knee Surgery, Sports Traumatology, Arthroscopy | Ausgabe 4/2015

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Abstract

Purpose

The purpose of this study was to identify the femoral insertion of the medial patellofemoral ligament (MPFL) and related osseous landmarks.

Methods

A total of 31 unpaired human cadaveric knees were studied. The MPFL was identified, and the site of its femoral insertion was marked. Three-dimensional images were created, and the location and morphology of the femoral insertion of the MPFL and related osseous structures were analyzed.

Results

The MPFL was identified in all knees. The femoral insertion of the MPFL was elliptical in shape, and the mean surface area was 56.5 ± 16.9 mm2. The characteristic features of the femoral insertion of the MPFL could not be identified, but the adductor tubercle was clearly identified in all knees. The centre of the femoral insertion of the MPFL was 10.6 ± 2.5 mm distal to the apex of the adductor tubercle on the long axis of the femur, and the position of the insertion site was consistent in all knees.

Conclusion

The adductor tubercle was clearly identified as an osseous landmark. The femoral insertion of the MPFL was approximately 10 mm distal to the adductor tubercle. These findings may improve understanding of the anatomy of the femoral insertion of the MPFL and may assist surgeons in performing anatomical reconstruction.
Literatur
1.
Amis AA, Firer P, Mountney J, Senavongse W, Thomas NP (2003) Anatomy and biomechanics of the medial patellofemoral ligament. Knee 10:215–220CrossRefPubMed
2.
Aragäo JA, Reis FP, de Vasconcelos DP, Feitosa VL, Nunes MA (2008) Metric measurements and attachment levels of the medial patellofemoral ligament: an anatomical study in cadavers. Clinics 63:541–544CrossRefPubMedCentralPubMed
3.
Baldwin JL (2009) The anatomy of the medial patellofemoral ligament. Am J Sports Med 37:2355–2361CrossRefPubMed
4.
Barnett AJ, Howells NR, Burston BJ, Ansari A, Eldridge JD (2012) Radiographic landmarks for tunnel placement in reconstruction of the medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc 20:2380–2384CrossRefPubMed
5.
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
6.
Dejour H, Walch G, Nove-Josserand L, Guier C (1994) Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc 2:19–26CrossRefPubMed
7.
Desio SM, Burks RT, Bachus KN (1998) Soft tissue restraints to lateral patellar translation in the human knee. Am J Sports Med 26:59–65PubMed
8.
Farr J, Schepsis A (2006) Reconstruction of the medial patellofemoral ligament for recurrent patellar instability. J Knee Surg 19:307–316CrossRefPubMed
9.
Feller JA, Feagin JA Jr, Garrett WE Jr (1993) The medial patellofemoral ligament revisited: an anatomical study. Knee Surg Sports Traumatol Arthrosc 1:184–186CrossRefPubMed
10.
Fithian DC, Paxton EW, Stone ML, Silva P, Davis DK, Elias DA, White LM (2004) Epidemiology and natural history of acute patellar dislocation. Am J Sports Med 32:1114–1121CrossRefPubMed
11.
Gelaude F, Vander Sloten J, Lauwers B (2008) Accuracy assessment of CT-based outer surface femur meshes. Comput Aided Surg 13:188–199CrossRefPubMed
12.
Hawkins RJ, Bell RH, Anisette G (1986) Acute patellar dislocations. The natural history. Am J Sports Med 14:117–120CrossRefPubMed
13.
Higuchi T, Arai Y, Takamiya H, Miyamoto T, Tokunaga D, Kubo T (2010) An analysis of the medial patellofemoral ligament length change pattern using open-MRI. Knee Surg Sports Traumatol Arthrosc 18:1470–1475CrossRefPubMed
14.
Kepler CK, Bogner EA, Hammoud S, Malcolmson G, Potter HG, Green DW (2011) Zone of injury of the medial patellofemoral ligament after acute patellar dislocation in children and adolescents. Am J Sports Med 39:1444–1449CrossRefPubMed
15.
LaPrade RF, Engerbretsen AH, Ly TV, Johansen S, Wentorf FA, Engebretsen L (2007) The anatomy of the medial part of the knee. J Bone Joint Surg Am 89:2000–2010CrossRefPubMed
16.
Maenpaa H, Lento M (1997) Patellar dislocation. The long-term results of nonoperative management in 100 patients. Am J Sports Med 25:213–217CrossRefPubMed
17.
Nakagawa K, Wada Y, Minamide M, Tsuchiya A, Moriya H (2002) Deterioration of long-term clinical results after the Elmslie-Trillat procedure for dislocation of the patella. J Bone Joint Surg Br 84:861–864CrossRefPubMed
18.
Nelitz M, Reichel H, Dornacher D (2012) Anatomical reconstruction of the medial patellofemoral ligament in children with open growth-plates. Arch Orthop Trauma Surg 132:1647–1651CrossRefPubMed
19.
Nelitz M, Dornacher D, Dreyhaupt J, Reichel H, Lippacher S (2011) The relation of the distal femoral physis and the medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc 19:2067–2071CrossRefPubMed
20.
Nomura E, Horiuchi Y, Kihara M (2000) Medial patellofemoral ligament restraint in lateral patellar translation and reconstruction. Knee 7:121–127CrossRefPubMed
21.
Nomura E, Inoue M, Osada N (2005) Anatomical analysis of the medial patellofemoral ligament of the knee, especially the femoral attachment. Knee Surg Sports Traumatol Arthrosc 13:510–515CrossRefPubMed
22.
Panagiotopoulos E, Strzelczyk P, Herrmann M, Scuderi G (2006) Cadaveric study on static medial patellar stabilizers: the dynamizing role of the vastus medialis obliquus on medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc 4:7–12CrossRef
23.
Philippot R, Boyer B, Testa R, Farizon F, Moyen B (2012) The role of the medial ligamentous structures on patellar tracking during knee flexion. Knee Surg Sports Traumatol Arthrosc 20:331–336CrossRefPubMed
24.
Philippot R, Chouteau J, Wegrzyn J, Testa R, Fessy MH, Moyen B (2009) Medial patellofemoral ligament anatomy: implications for its surgical reconstruction. Knee Surg Sports Traumatol Arthrosc 17:475–479CrossRefPubMed
25.
Redfern J, Kamath G, Burks R (2010) Anatomical confirmation of the use of radiographic landmarks in medial patellofemoral ligament reconstruction. Am J Sports Med 38:293–297CrossRefPubMed
26.
Sallay PI, Poggi J, Speer KP, Garrett WE (1996) Acute dislocation of the patella: a correlative pathoanatomic study. Am J Sports Med 24:52–60CrossRefPubMed
27.
Sanders TG, Morrison WB, Singleton BA, Miller MD, Cornum KG (2001) Medial patellofemoral ligament injury following acute transient dislocation of the patella: MR findings with surgical correction in 14 patients. J Comput Assist Tomogr 25:957–962CrossRefPubMed
28.
Sauli P (2008) Acute patellar dislocation in children and adolescents: a randomized clinical trial. J Bone Joint Surg Am 90:463–470CrossRef
29.
Schottle PB, Schmeling A, Rosenstiel N, Weiler A (2007) Radiographic landmarks for femoral tunnel placement in medial patellofemoral ligament reconstruction. Am J Sports Med 35:801–804CrossRefPubMed
30.
Schottle PB, Schmeling A, Romeo J, Weiler A (2009) Anatomical reconstruction of the medial patellofemoral ligament using a free gracilis autograft. Arch Orthop Trauma Surg 129:305–309CrossRefPubMed
31.
Smirk C, Morris H (2003) The anatomy and reconstruction of the medial patellofemoral ligament. Knee 10:221–227CrossRefPubMed
32.
Steensen RN, Dopirak RM, McDonald WG 3rd (2004) The anatomy and isometry of the medial patellofemoral ligament: implications for reconstruction. Am J Sports Med 32:1509–1513CrossRefPubMed
33.
Stephen JM, Lumpaopong P, Deehan DJ, Kader D, Amis AA (2012) The medial patellofemoral ligament: location of femoral attachment and length change patterns resulting from anatomic and nonanatomic attachments. Am J Sports Med 40:1871–1879CrossRefPubMed
34.
Tajima G, Nozaki M, Iriuchishima T, Ingham SJ, Shen W, Smolinski P, Fu FH (2009) Morphology of the tibial insertion of the posterior cruciate ligament. J Bone Joint Surg Am 91:859–866CrossRefPubMed
35.
Tateishi T, Tsuchiya M, Motosugi N, Asahina S, Ikeda H, Cho S, Muneta T (2011) Graft length change and radiographic assessment of femoral drill hole position for medial patellofemoral ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 19:400–407CrossRefPubMed
36.
Tuxoe JI, Teir M, Nielsen PL (2002) The medial patellofemoral ligament: a dissection study. Knee Surg Sports Traumatol Arthrosc 10:138–140CrossRefPubMed
37.
Victor J, Wong P, Witvrouw E, Sloten JV, Bellemans J (2009) How isometric are the medial patellofemoral, superficial medial collateral, and lateral collateral ligaments of the knee? Am J Sports Med 37:2028–2036CrossRefPubMed
38.
Yercan HS, Erkan S, Okcu G, Ozalp RT (2011) A novel technique for reconstruction of the medial patellofemoral ligament in skeletally immature patients. Arch Orthop Trauma Surg 13:1059–1065CrossRef
39.
Yoo YS, Chang HG, Seo YJ, Byun JC, Lee GK, Im H, Song SY (2012) Changes in the length of the medial patellofemoral ligament: an in vivo analysis using 3-dimensional computed tomography. Am J Sports Med 40:2142–2148CrossRefPubMed
Metadaten
Titel
Morphology of the femoral insertion site of the medial patellofemoral ligament
verfasst von
Kotaro Fujino
Goro Tajima
Jun Yan
Youichi Kamei
Moritaka Maruyama
Sanjuro Takeda
Shuhei Kikuchi
Tadashi Shimamura
Publikationsdatum
01.04.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Knee Surgery, Sports Traumatology, Arthroscopy / Ausgabe 4/2015
Print ISSN: 0942-2056
Elektronische ISSN: 1433-7347
DOI
https://doi.org/10.1007/s00167-013-2797-0

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