Origin and insertion of the medial patellofemoral ligament: a systematic review of anatomy

Arash Aframian; Toby O. Smith; T. Duncan Tennent; Justin Peter Cobb; Caroline Blanca Hing

doi:10.1007/s00167-016-4272-1

Origin and insertion of the medial patellofemoral ligament: a systematic review of anatomy

Arash Aframian, Toby O. Smith, T. Duncan Tennent, Justin Peter Cobb, Caroline Blanca Hing

Research output: Contribution to journal › Article › peer-review

72 Citations (Scopus)

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Abstract

Purpose: The Medial Patellofemoral Ligament (MPFL) is the major medial soft-tissue stabiliser of the patella, originating from the medial femoral condyle and inserting onto the medial patella. The exact position reported in the literature varies. Understanding the true anatomical origin and insertion of the MPFL is critical to successful reconstruction. The purpose of this systematic review was to determine these locations.

Methods: A systematic search of published (AMED, CINAHL, MEDLINE, EMBASE, PubMed and Cochrane Library) and unpublished literature databases was conducted from their inception to the 3rd February 2016. All papers investigating the anatomy of the MPFL were eligible. Methodological quality was assessed using a modified CASP tool. A narrative analysis approach was adopted to synthesise the findings.

Results: After screening and review of 2045 papers, a total of studies investigating the relevant anatomy were included. From this, the origin appears to be from an area rather than (as previously reported) a single point on the medial femoral condyle. The weighted average length was 56mm with an ‘hourglass’ shape, fanning out at both ligament ends.

Conclusion: The MPFL is an hourglass shaped structure running from a triangular space between the adductor tubercle, medial femoral epicondyle and gastrocnemius tubercle and inserts onto the superomedial aspect of the patella. Awareness of anatomy is critical for assessment, anatomic repair and successful surgical patellar stabilisation.

Original language	English
Pages (from-to)	3755–3772
Number of pages	18
Journal	Knee Surgery, Sports Traumatology, Arthroscopy
Volume	25
Issue number	12
Early online date	8 Sep 2016
DOIs	https://doi.org/10.1007/s00167-016-4272-1
Publication status	Published - Dec 2017

Keywords

Medial patellofemoral ligament
anatomy
insertion
origin
MPFL
attachments
Reconstruction

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Cite this

@article{c27c50fa627c41a297a798cc45ef62dc,

title = "Origin and insertion of the medial patellofemoral ligament: a systematic review of anatomy",

abstract = "Purpose: The Medial Patellofemoral Ligament (MPFL) is the major medial soft-tissue stabiliser of the patella, originating from the medial femoral condyle and inserting onto the medial patella. The exact position reported in the literature varies. Understanding the true anatomical origin and insertion of the MPFL is critical to successful reconstruction. The purpose of this systematic review was to determine these locations. Methods: A systematic search of published (AMED, CINAHL, MEDLINE, EMBASE, PubMed and Cochrane Library) and unpublished literature databases was conducted from their inception to the 3rd February 2016. All papers investigating the anatomy of the MPFL were eligible. Methodological quality was assessed using a modified CASP tool. A narrative analysis approach was adopted to synthesise the findings. Results: After screening and review of 2045 papers, a total of studies investigating the relevant anatomy were included. From this, the origin appears to be from an area rather than (as previously reported) a single point on the medial femoral condyle. The weighted average length was 56mm with an {\textquoteleft}hourglass{\textquoteright} shape, fanning out at both ligament ends. Conclusion: The MPFL is an hourglass shaped structure running from a triangular space between the adductor tubercle, medial femoral epicondyle and gastrocnemius tubercle and inserts onto the superomedial aspect of the patella. Awareness of anatomy is critical for assessment, anatomic repair and successful surgical patellar stabilisation.",

keywords = "Medial patellofemoral ligament, anatomy, insertion, origin, MPFL, attachments, Reconstruction",

author = "Arash Aframian and Smith, {Toby O.} and Tennent, {T. Duncan} and Cobb, {Justin Peter} and Hing, {Caroline Blanca}",

year = "2017",

month = dec,

doi = "10.1007/s00167-016-4272-1",

language = "English",

volume = "25",

pages = "3755–3772",

journal = "Knee Surgery, Sports Traumatology, Arthroscopy",

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T1 - Origin and insertion of the medial patellofemoral ligament: a systematic review of anatomy

AU - Aframian, Arash

AU - Smith, Toby O.

AU - Tennent, T. Duncan

AU - Cobb, Justin Peter

AU - Hing, Caroline Blanca

PY - 2017/12

Y1 - 2017/12

N2 - Purpose: The Medial Patellofemoral Ligament (MPFL) is the major medial soft-tissue stabiliser of the patella, originating from the medial femoral condyle and inserting onto the medial patella. The exact position reported in the literature varies. Understanding the true anatomical origin and insertion of the MPFL is critical to successful reconstruction. The purpose of this systematic review was to determine these locations. Methods: A systematic search of published (AMED, CINAHL, MEDLINE, EMBASE, PubMed and Cochrane Library) and unpublished literature databases was conducted from their inception to the 3rd February 2016. All papers investigating the anatomy of the MPFL were eligible. Methodological quality was assessed using a modified CASP tool. A narrative analysis approach was adopted to synthesise the findings. Results: After screening and review of 2045 papers, a total of studies investigating the relevant anatomy were included. From this, the origin appears to be from an area rather than (as previously reported) a single point on the medial femoral condyle. The weighted average length was 56mm with an ‘hourglass’ shape, fanning out at both ligament ends. Conclusion: The MPFL is an hourglass shaped structure running from a triangular space between the adductor tubercle, medial femoral epicondyle and gastrocnemius tubercle and inserts onto the superomedial aspect of the patella. Awareness of anatomy is critical for assessment, anatomic repair and successful surgical patellar stabilisation.

AB - Purpose: The Medial Patellofemoral Ligament (MPFL) is the major medial soft-tissue stabiliser of the patella, originating from the medial femoral condyle and inserting onto the medial patella. The exact position reported in the literature varies. Understanding the true anatomical origin and insertion of the MPFL is critical to successful reconstruction. The purpose of this systematic review was to determine these locations. Methods: A systematic search of published (AMED, CINAHL, MEDLINE, EMBASE, PubMed and Cochrane Library) and unpublished literature databases was conducted from their inception to the 3rd February 2016. All papers investigating the anatomy of the MPFL were eligible. Methodological quality was assessed using a modified CASP tool. A narrative analysis approach was adopted to synthesise the findings. Results: After screening and review of 2045 papers, a total of studies investigating the relevant anatomy were included. From this, the origin appears to be from an area rather than (as previously reported) a single point on the medial femoral condyle. The weighted average length was 56mm with an ‘hourglass’ shape, fanning out at both ligament ends. Conclusion: The MPFL is an hourglass shaped structure running from a triangular space between the adductor tubercle, medial femoral epicondyle and gastrocnemius tubercle and inserts onto the superomedial aspect of the patella. Awareness of anatomy is critical for assessment, anatomic repair and successful surgical patellar stabilisation.

KW - Medial patellofemoral ligament

KW - anatomy

KW - insertion

KW - origin

KW - MPFL

KW - attachments

KW - Reconstruction

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DO - 10.1007/s00167-016-4272-1

M3 - Article

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JO - Knee Surgery, Sports Traumatology, Arthroscopy

JF - Knee Surgery, Sports Traumatology, Arthroscopy

SN - 0942-2056

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ER -