Medial Patellofemoral Retinaculum
The medial patellar retinaculum plays two important roles in the knee. The medial patellofemoral ligament MPFL is a continuation of the deep retinaculum and vastus medialis oblique.
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Groove is normally about 1 cm higher than the medial.
Medial patellofemoral retinaculum
. Asmore traditional surgical tech-niques donotreestablish theintegrity ofthe medial patellofemoral ligament attheadduc-. Medial patellofemoral ligament tearsoccurred atornearthefemoral attachment resulting in significant patellar instability inallcasesThe patellawasfreely subluxable andinmany casescould bedislocated onphysical exami-nation. The medial patellofemoral ligament is one of the main components of the middle layer of the medial patellar retinaculum and is one of the major medial patellar stabilizers 2.The medial patellofemoral ligament MPFL a continuation of the Vastus Medialis Oblique VMO muscle fibers extends from the superior inner side of the patella to the medial femur and helps prevent lateral displacement of the patella during the first 20-30 of knee flexion. The fascia fibrous expansions of the vastus muscles the MPFL and the medial patellomeniscal ligament. The LPTL attaches directly to the distal pole of the patella and sends fibers both into the lateral meniscus and into the underlying tibia.
From this review it emerges that medial capsule reefing is a reliable option in the treatment for patellar instability. The VMO is the only muscle that provides a medial force and is therefore of particular importance in stabilizing the patella. The medial patellar retinaculum includes four structures.
The medial retinaculum was repaired duplicated or augmented in 63 of 70 patients but the medial patellofemoral ligament was not specifically addressed. The femoral insertion of the MPFL was located just behind the femoral insertion of the MCL in 12 knees. It forms part of the fibrous capsule of the knee.
Such prior surgeries may include. Static stability is provided via the articular capsule the femoral. The deep layer has contributions from the medial patellofemoral ligament and fascial thickenings.
Reconstruction of the medial patellofemoral retinaculum is often necessary in the surgical treatment of recurrent patellar instability. The deep layer mirrors the medial structures and consists of the lateral patellofermoral ligament LPFL the deep transverse retinaculum and the patellotibial ligament LPTL. Re-dislocation rate is variable and can oc.
Fifty-four patients had a lateral release without clear indications. Lateral release in which the. Medial Patellofemoral Ligament Repair and Reconstruction Proper stabilization of the patella is also affected by the soft tissue structures ligaments and muscles surrounding the knee.
We showed in 1985 that some patients with chronic anterior knee pain associated with malalignment show evidence of small nerve injury 2 in the lateral retinaculum Fig. It serves as the insertion of the vastus medialis on the tibia. Similarly medial retinaculum might be recurrently stretched or abnormally stressed in patients with patellar imbalance.
Recently attention has been focused on the medial patellofemoral ligament MPFL and its reconstruction yet this structure is only one component of a complex medial retinaculum. In lateral patellar dislocation vulgus hyperextension injuries associated with MCL tear Seen as free floating or mass like medial retinaculum on axial MR Associated with edemahemorrhage Tight lateral retinaculum. The superficial layer originates from the lowest fibers of the vastus medialis muscle sartorius and the medial collateral ligament.
Arthroscopic minimally invasive surgery in which torn tissue in the patellofemoral joint is cleaned up Medial imbrication a procedure in which the surgeon tightens the MPFL by taking a tuck in it similar to tightening a. It can be proposed with good expectations since the outcomes are positive and stable even at longer FU and complications rates are low. Multiple surgeons were involved with patients having individually adjusted procedures according to Nikku et al.
Medial and lateral patellofemoral joint retinaculum thicknesses of 32 knees 16 with patellofemoral pain and 16 asymptomatic were measured with Bmode ultrasound at 05 1 and 15cm from the patella border. In patellar and quadriceps tendon tears Medial retinacular tear. The medial patellar retinaculum is a fibrous expansion comprising of superficial and deep layers.
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