title: Cadaveric study of the secondary medial patellar restraints: patellotibial and patellomeniscal ligaments.
abstract: OBJECTIVE
  To detail the anatomy of the medial patella stabilizers, medial patellotibial (MPTL), and medial patellomeniscal ligaments (MPML), focusing on the points of origin and insertion, length, thickness, width, and fibres orientation to study the frequency of anatomical variations and the anatomy of these ligaments, thereby improving surgical techniques.
  
  
  METHODS
  Thirty dissected knees were analysed. A digital caliper was used to measure the length, thickness, and width, as well as the mid-point of the ligaments insertion and the distance from the MPTL insertion to the articular surface of the tibia. The angle of inclination of the ligaments was calculated in the coronal plane. The collected data were tabulated and statistically analysed.
  
  
  RESULTS
  MPTL was present in 90 % as a visible thickening of the deep medial retinaculum and exhibiting only one anatomical variation. The MPML was absent in one of the dissected knees, and one anatomical variation was found. The tilt angle of the ligaments was very similar, with an average of 22.2° ± 7.6° for the MPTL and 24.2° ± 6.6° for the MPML.
  
  
  CONCLUSIONS
  The MPTL is a long visible structure of the deep layer of the medial retinaculum, but with a distinct origin and insertion. The MPML is thicker with an angular direction similar to MPTL. The presence of these ligaments in most of the specimens studied suggests that the real anatomical and biomechanical importance of these ligaments should be further investigated because they play a role in the patellar stability.
authors.affiliation: Knee Surgery Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa of São Paulo, Sao Paulo, SP, Brazil. camilacohen@kaleka.com.br.
authors.forename: Camila Cohen
authors.initials: CC
authors.lastname: Kaleka
authors.affiliation: Knee Surgery Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa of São Paulo, Sao Paulo, SP, Brazil.
authors.forename: Leandro Jun
authors.initials: LJ
authors.lastname: Aihara
authors.affiliation: Trauma Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa of São Paulo, Sao Paulo, SP, Brazil.
authors.forename: Anderson
authors.initials: A
authors.lastname: Rodrigues
authors.affiliation: Knee Surgery Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa of São Paulo, Sao Paulo, SP, Brazil.
authors.forename: Sebastião Ferreira
authors.initials: SF
authors.lastname: de Medeiros
authors.affiliation: Knee Surgery Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa of São Paulo, Sao Paulo, SP, Brazil.
authors.forename: Victor Marques
authors.initials: VM
authors.lastname: de Oliveira
authors.affiliation: Knee Surgery Group, Department of Orthopedics and Traumatology, School of Medical Sciences, Santa Casa of São Paulo, Sao Paulo, SP, Brazil.
authors.forename: Ricardo
authors.initials: R
authors.lastname: de Paula Leite Cury
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D005260:Female; D006801:Humans; D007719:Knee Joint / Q000502:physiology; D008023:Ligaments, Articular; D008297:Male; D008875:Middle Aged; D010329:Patella; D031222:Patellar Dislocation; D012149:Restraint, Physical
keywords: Knee; Ligament; Patella; Patellar dislocation; Patellofemoral Joint