TY - JOUR
T1 - Concepts of the Distal Medial Patellar Restraints
T2 - Medial Patellotibial Ligament and Medial Patellomeniscal Ligament
AU - Hinckel, Betina B.
AU - Lipinski, Lukasz
AU - Arendt, Elizabeth A.
PY - 2019/12/1
Y1 - 2019/12/1
N2 - The important medial patellar ligamentous restraints to lateral dislocation are the proximal group (the medial quadriceps tendon femoral ligament and the medial patellofemoral ligament) and the distal group [medial patellotibial ligament (MPTL) and medial patellomeniscal ligament (MPML)]. The MPTL patellar insertion is at inferomedial border of patella and tibial insertion is in the anteromedial tibia. The MPML originates in the inferomedial patella, right proximal to the MPTL, inserting in the medial meniscus. On the basis of anatomy and biomechanical studies, the MPTL and MPML are more important in 2 moments during knee range of motion: Terminal extension, when it directly counteracts quadriceps contraction. In a systematic review on MPTL reconstructions 19 articles were included detailing the clinical outcomes of 403 knees. All were case series. Overall, good and excellent outcomes were achieved in >75% of cohorts in most studies and redislocations were <10%, with or without the association of the medial patellofemoral ligament. The MPTL is a relevant additional tool to proximal restraint reconstruction in select patient profiles; however, more definitive clinical studies are necessary to better define surgical indications.
AB - The important medial patellar ligamentous restraints to lateral dislocation are the proximal group (the medial quadriceps tendon femoral ligament and the medial patellofemoral ligament) and the distal group [medial patellotibial ligament (MPTL) and medial patellomeniscal ligament (MPML)]. The MPTL patellar insertion is at inferomedial border of patella and tibial insertion is in the anteromedial tibia. The MPML originates in the inferomedial patella, right proximal to the MPTL, inserting in the medial meniscus. On the basis of anatomy and biomechanical studies, the MPTL and MPML are more important in 2 moments during knee range of motion: Terminal extension, when it directly counteracts quadriceps contraction. In a systematic review on MPTL reconstructions 19 articles were included detailing the clinical outcomes of 403 knees. All were case series. Overall, good and excellent outcomes were achieved in >75% of cohorts in most studies and redislocations were <10%, with or without the association of the medial patellofemoral ligament. The MPTL is a relevant additional tool to proximal restraint reconstruction in select patient profiles; however, more definitive clinical studies are necessary to better define surgical indications.
KW - MPML
KW - MPTL
KW - medial patella ligaments
KW - medial patellomeniscal ligament
KW - medial patellotibial ligament
KW - patellar dislocation
KW - patellar instability
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UR - http://www.scopus.com/inward/citedby.url?scp=85074547263&partnerID=8YFLogxK
U2 - 10.1097/JSA.0000000000000269
DO - 10.1097/JSA.0000000000000269
M3 - Review article
C2 - 31688532
AN - SCOPUS:85074547263
SN - 1062-8592
VL - 27
SP - 143
EP - 149
JO - Sports medicine and arthroscopy review
JF - Sports medicine and arthroscopy review
IS - 4
ER -