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Concepts of the Distal Medial Patellar Restraints

Medial Patellotibial Ligament and Medial Patellomeniscal Ligament

Hinckel, Betina B. MD, PhD*; Lipinski, Lukasz MD; Arendt, Elizabeth A. MD

Sports Medicine and Arthroscopy Review: December 2019 - Volume 27 - Issue 4 - p 143–149
doi: 10.1097/JSA.0000000000000269
Review Articles

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.

*Department of Orthopaedic Surgery, William Beaumont Hospital, Royal Oak, MI

Orthopedics and Pediatric Orthopedics Clinic, Medical University in Lodz, Poland

Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN

Disclosure: The authors declare no conflict of interest.

Reprints: Betina B. Hinckel, MD, PhD, Department of Orthopaedic Surgery, William Beaumont Hospital, 10000 Telegraph Road, Suite 100, Taylor, Royal Oak, MI 48180.

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