Medial Patellofemoral Ligament
Introduction
Alternative Names
- MPFL
- Medial patellofemoral complex
- Medial patellar stabilizing ligament
- Medial patellar restraint ligament
- Medial patellar retinaculum
General Introduction
- Primary passive stabilizer preventing lateral patellar displacement, especially from 0–30° knee flexion
- Key component of the medial patellofemoral stabilizing complex
- Essential for maintaining patellar tracking within the trochlear groove
- Commonly injured in acute lateral patellar dislocations and associated with recurrent instability
Anatomic Description
- Thin, fan-shaped ligament located on the medial aspect of the knee[3]
- Ligamentous anchor between the patella and femur
- Origin: region between the medial femoral epicondyle and adductor tubercle
- Femoral attachments: 1.9 mm anterior, 3.8 mm distal to the adductor tubercle and 10.6 mm proximal and 8.8 mm posterior to the medial epicondyle[4]
- Insertion: superomedial border of the patella
- Patellar attachments: broad insertion onto the medial superior half of the patella (deep to the Vastus Medialis Obliquus
- Blends with Vastus Medialis, Medial Patellar Retinaculum
- Average length: ~45–65 mm
- Part of a broader medial soft-tissue restraint complex
Actions
- Prevents excessive lateral movement of the patella[5]
- Most important patellar stabilizer during the first 30° of knee flexion[6]
- Provides 50%–60% of medial restraint to lateral subluxation
- Trochlear groove providing further patellar stability with deeper knee flexion
Vascular Supply
- Supplied by branches of the genicular arterial network[7]
- Superior medial genicular artery
- Descending genicular artery
Innervation
- Innervated by:
- Femoral nerve (via nerve to vastus medialis)
- Saphenous nerve (sensory contribution)
- Contributes to proprioception and nociception of the medial knee
Clinical Significance
Pathology
Surgical
- MPFL reconstruction commonly performed for recurrent instability
- Important anatomic landmark to help determine if patella subluxation or dislocatoin ocurred
See Also
References
- ↑ Mitrogiannis, Leonidas, et al. "Cadaveric-biomechanical study on medial retinaculum: its stabilising role for the patella against lateral dislocation." Folia morphologica 77.4 (2018): 742-747.
- ↑ Hiemstra, Laurie A., et al. "Effect of trochlear dysplasia on outcomes after isolated soft tissue stabilization for patellar instability." The American journal of sports medicine 44.6 (2016): 1515-1523.
- ↑ Nomura, Eiji, and Masatoshi Inoue. "Anatomy of the medial patellofemoral ligament and its surgical implications." Knee Surgery, Sports Traumatology, Arthroscopy, vol. 11, no. 2, 2003, pp. 113–119.
- ↑ LaPrade RF, Engebretsen AH, Ly TV, Johansen S, Wentorf FA, Engebretsen L, et al. The anatomy of the medial part of the knee. J Bone Joint Surg Am. 2007;89:2000–10.
- ↑ LaPrade, Robert F., et al. "The anatomy of the medial part of the knee." The Journal of Bone and Joint Surgery, vol. 89, no. 9, 2007, pp. 2000–2010.
- ↑ Stephen JM, Lumpaopong P, Deehan DJ, Kader D, Amis AA. The medial patellofemoral ligament: Location of femoral attachment and length change patterns resulting from anatomic and nonanatomic attachments. Am J Sports Med. 2012;40:1871–9.
- ↑ Amis, Andrew A., et al. "Anatomy and biomechanics of the medial patellofemoral ligament." The Knee, vol. 10, no. 3, 2003, pp. 215–220.