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The Ribbon-shaped Femoral Footprint of the Medial Patellofemoral Ligament

Implications for Reconstruction

Tanaka, Miho J. MD*,†; Farr, Jack II MD*,†

Sports Medicine and Arthroscopy Review: December 2019 - Volume 27 - Issue 4 - p 150–153
doi: 10.1097/JSA.0000000000000238
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The medial patellofemoral ligament (MPFL) is the primary static stabilizer to lateral translation of the patella and serves as part of the medial patellar soft tissue restraints. Because of the sensitivity of MPFL graft function after reconstruction to the position of the femoral tunnel, many studies have aimed to identify the exact point of the femoral origin, as well as defining techniques to confirm this position intraoperatively. We describe the ribbon-shaped footprint of the MPFL on the medial femur and the associated difficulty in identifying the origin as a single “point.” Varying isometry and biomechanical functions have been shown to exist within the most proximal and most distal fibers, suggesting the function of the MPFL may not be fully recreated with a tubular graft in a round tunnel. We review the anatomical descriptions of the elongated femoral footprint of the MPFL and describe our surgical technique to recreate this.

*Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, MD

OrthoIndy, Indianapolis, IN

Disclosure: The authors declare no conflict of interest.

Reprints: Miho J. Tanaka, MD, Johns Hopkins Department of Orthopaedic Surgery, 601 N. Caroline St. JHOC 5250, Baltimore, MD 21287.

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