Are location, proportion and length of VM patellar attachment aetiological factors in patellofemoral dysfunction? A systematic review

This paper systematically reviews the evidence to determine where the distal vastus medialis (VM) attaches on the patella, the proportion of VM which attaches onto the patella, and the length of the distal VM tendon, and whether these factors are aetiological factors for patellofemoral disorders. Following an electronic and hand search of all full text, English-language papers assessing the distal VM attachment to the patella through cadaver dissection or radiological imaging, eight papers were reviewed. The findings suggest that the distal VM attached proximal or the mid point of the patella in the majority of cases. Ten percent of the total length of distal VM inserts onto the patella, whilst the length of distal VM tendon ranged from 1.4 to 3.5 cm. It was unclear whether these factors were aetiological factors in patellofemoral disorders due to the paucity of well conducted and presented literature evaluating this area.