title: The anatomy and isometry of a quasi-anatomical reconstruction of the medial patellofemoral ligament.
abstract: OBJECTIVE
  To describe the anatomy of the medial patellofemoral ligament (MPFL) and its relationship to the Adductor Magnus (AM) tendon as well as the behaviour exhibited in length changes during knee flexion.
  
  
  METHODS
  Ten cadaveric knees were dissected. The length from the superior and inferior patellar origin of the MPFL to its femoral insertion was measured at different degrees of knee flexion (0°, 30°, 60°, 90° and 120°). The same measures were made from both patellar origins of the MPFL up to the femoral insertion of the AM. The distance between the insertion of the AM and the Hunter canal was also measured.
  
  
  RESULTS
  In general, isometry up to 90° was seen in all measures of the MPFL and those of the AM. The most isometric behaviour was seen in 2 measures: the length of the AM femoral insertion up to the inferior origin of the MPFL on the patella and the length of the femoral insertion of the MPFL up to the inferior origin of the MPFL on the patella. Similar behaviour was seen regardless of the anatomical or quasi-anatomical femoral point of attachment (n.s.). The distance from the AM tendon to the Hunter canal had a mean value of 78.6 mm (SD 9.4 mm).
  
  
  CONCLUSIONS
  The behaviour exhibited during the changes in the length of the anatomical femoral footprint of the MPFL and the AM is similar. Neurovascular structures were not seen at risk. This is relevant in the daily clinical practice since the AM tendon might be a suitable point of insertion for MPFL reconstruction.
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Hospital del Mar, Universitat Autònoma de Barcelona, Passeig Marítim, 25, Barcelona, Spain. dperezprieto@hospitaldelmar.cat.
authors.forename: Daniel
authors.initials: D
authors.lastname: Pérez-Prieto
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Hospital del Mar, Universitat Autònoma de Barcelona, Passeig Marítim, 25, Barcelona, Spain.
authors.forename: Bruno
authors.initials: B
authors.lastname: Capurro
authors.affiliation: Orthopedic Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: Pablo E
authors.initials: PE
authors.lastname: Gelber
authors.affiliation: Hospital Terres de l'Ebre, Tortosa, Spain.
authors.forename: Gerard
authors.initials: G
authors.lastname: Ginovart
authors.affiliation: Faculty of Medicine, Universitat de Girona, Girona, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Reina
authors.affiliation: Hospital 9 de Octubre, Valencia, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Sanchis-Alfonso
authors.affiliation: Department of Orthopaedic Surgery and Traumatology, Hospital del Mar, Universitat Autònoma de Barcelona, Passeig Marítim, 25, Barcelona, Spain.
authors.forename: Joan C
authors.initials: JC
authors.lastname: Monllau
mesh_terms: D000368:Aged; D001837:Body Weights and Measures; D002102:Cadaver; D004210:Dissection; D005260:Female; D005269:Femur / Q000033:anatomy & histology; D006801:Humans; D007719:Knee Joint / Q000033:anatomy & histology; D008023:Ligaments, Articular / Q000033:anatomy & histology*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000033:anatomy & histology*; D057071:Patellofemoral Joint / Q000033:anatomy & histology*; D016059:Range of Motion, Articular; D013710:Tendons / Q000033:anatomy & histology; D013848:Thigh
keywords: Femoral attachment; Medial patellofemoral ligament; Patellofemoral instability; Quasi-anatomical reconstruction