title: Anatomical study of the medial patello-femoral ligament: landmarks for its surgical reconstruction.
abstract: OBJECTIVE
  The aim of this dissection study was to describe the anatomical insertions of the medial patello-femoral ligament (MPFL), and to assess its relationship with surrounding structures to improve its surgical reconstruction.
  
  
  METHODS
  Twelve knees (7 cadavers) were included for the study. Measurements and general features of the MPFL were assessed: lengths, widths and insertions.
  
  
  RESULTS
  The MPFL was found in all knees, presenting a triangular shape, and extending from the medial part of the patella to its femoral insertion (its length was of 59 ± 6.6 mm), distal to the adductor tubercle. The mean femoral insertion of the MPFL was 7.2 ± 2.7 mm proximal and 7.4 ± 4.0 mm posterior to the medial femoral epicondyle (MFE). It was also at a mean 11 ± 2.8 mm distal and 1.3 ± 2.1 mm posterior to the adductor tubercle, and 22 ± 6.4 mm anterior to the posterior condyle. We did not find any double-bundle organization on the patellar insertion. The width of the MPFL was 8.8 ± 2.9 mm at the femoral insertion, 27 ± 5.9 mm at the patellar insertion, and 12 ± 3.1 mm in the middle of the MPFL. The vastus medialis obliquus was found to be inserted on the superior part of the MPFL.
  
  
  CONCLUSIONS
  The adductor tubercle appeared to be a better landmark than the MFE for the femoral tunnel positioning during surgical reconstructions of the MPFL because it was easier to identify and its relationship with the femoral insertion of the MPFL was constant (10 mm below).
authors.affiliation: Faculté de Médecine Lyon Sud-Charles Mérieux, Laboratoire d'Anatomie, 165 Chemin du Petit Revoyet, BP 12, 69921, Oullins Cedex, France, anthony.viste@chu-lyon.fr.
authors.forename: Anthony
authors.initials: A
authors.lastname: Viste
authors.forename: Florian
authors.initials: F
authors.lastname: Chatelet
authors.forename: Romain
authors.initials: R
authors.lastname: Desmarchelier
authors.forename: Michel-Henri
authors.initials: MH
authors.lastname: Fessy
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D059925:Anatomic Landmarks; D002102:Cadaver; D004210:Dissection; D005260:Female; D005269:Femur / Q000033:anatomy & histology* / Q000601:surgery; D006801:Humans; D007719:Knee Joint / Q000033:anatomy & histology* / Q000601:surgery; D008297:Male; D017888:Medial Collateral Ligament, Knee / Q000033:anatomy & histology* / Q000601:surgery; D017847:Patellar Ligament / Q000033:anatomy & histology* / Q000601:surgery; D019651:Plastic Surgery Procedures