The anatomy and reconstruction of the medial patellofemoral ligament.
BACKGROUND
Reconstruction of the MPFL for recurrent and acute lateral dislocation of the patella is becoming more accepted. This study aimed to further define the medial patellofemoral ligament (MPFL) anatomy and to describe the most suitable sites for graft attachment when reconstructing the MPFL.


METHODS
Anatomical dissection was performed on 25 embalmed knee specimens. Four separate specimens were used to assess graft fixation points. Sites were tested for isometricity from 0 to 120 degrees of knee flexion. Length patterns were considered isometric if there was less than 5 mm of length change throughout range of motion.


RESULTS
The MPFL attaches from the posterior part of the medial epicondyle, to the superomedial patella, the under-surface of vastus medialis, and the quadriceps tendon. Optimal attachment points for an MPFL graft were the superior patella and the femoral attachment points of the MPFL (just distal to the adductor tubercle) and points posterior and inferior to this.


CONCLUSIONS
We have defined the anatomy and kinematics of the MPFL with reconstruction of this ligament in mind.
Smirk
Cameron
C
Centre for Sports Medicine Research and Education (CSMRE), The University of Melbourne, Australia.
Morris
Hayden
H
D019645:Arthroplasty, Replacement, Knee; D001696:Biomechanical Phenomena; D005269:Femur / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D017888:Medial Collateral Ligament, Knee / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D010329:Patella / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D031222:Patellar Dislocation / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D017847:Patellar Ligament / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery*; D010818:Practice Patterns, Physicians'; D016059:Range of Motion, Articular / Q000502:physiology; D015203:Reproducibility of Results