The medial patellofemoral ligament (MPFL) has been widely accepted to function as “the primary static restraint to lateral patellar displacement.” However, current growing evidence suggests that there is a complex of medial patellofemoral/tibial ligaments, both proximal [MPFL, and medial quadriceps tendon femoral ligament (MQTFL)], and distal (medial patellotibial ligament and the medial patellomeniscal ligament) which restrain lateral patellar translation at different degrees of knee flexion. Specifically, the MQTFL has gained popularity over the last decade because of pure soft tissue attachments into the extensor mechanism that allow for avoidance of drilling tunnels into the patella during reconstruction. The purpose of this article was to report on the current knowledge (anatomy, biomechanics, diagnosis, indications for surgery, and techniques) on the proximal medial patellar restraints, namely the MPFL and the MQTFL, collectively referred to as the proximal medial patellar restraints.
*Rush University Hospital, Chicago, IL
†“Mirai” Institute: Trauma, Orthopaedics and Physical Therapy
‡“ARS Medicinalis” Foundation, Warsaw, Poland
§Twin Cities Orthopedics, Edina, MN
∥Orthopedic Associates of Hartford, University of Connecticut School of Medicine, Farmington, CT
Disclosure: The authors declare no conflict of interest.
Reprints: Jorge Chahla, MD, PhD, Rush University Hospital, Midwest Orthopaedics at Rush, 1611 W Harrison Street, Ste 300, Chicago, IL 60612.