BLOG: Update on medial patellofemoral anatomy, implications for reconstruction

Issue: March 2016

In the Patellofemoral Update in this issue of Orthopaedics Today Europe, Miho J. Tanaka, MD, discusses key landmarks of the medial patellofemoral ligament and reasons why this name for the ligament may be incorrect based on anatomical findings.

Perspective from Elvire Servien, MD, PhD

Elvire Servien, MD, PhD, of Centre Albert Trillat, Department of Orthopaedic Surgery, in Lyon, provides her comments on this topic.

Patellofemoral Update focuses on the causes, prevention and treatment of patellofemoral disorders. The blog is sponsored by The Patellofemoral Foundation whose mission is to improve the care of individuals with anterior knee pain through targeted education and research. The Patellofemoral Foundation offers additional online education resources on its website.

Members of the Patellofemoral Foundation review and add clinical perspective to recently published studies on the causes, prevention and treatment of patellofemoral disorders. The twice monthly blogs are edited by John P. Fulkerson, MD, and can be found on www.healio.com/orthopaedics. To read all the Patellofemoral Update blogs, click here.

Perspective

Elvire Servien, MD, PhD

Dr. Tanaka gives some baselines on medial patellofemoral ligament (MPFL) anatomy, but also emphasizes it is maybe inaccurate to use the term MPFL as describing the ligament between the femur and the patella in patellar instability.

For this reason, the author proposes to use the term medial patellofemoral complex or MPFC. So I would say maybe we do not perform a reconstruction of the MPFL, but for sure we perform a reconstruction of the medial retinaculum or at least a part of it.

A nice summary of the MPFL anatomy was given about both sides (patellar and femoral), and its anatomic variability. However, all the anatomic studies are performed on normal knees without trochlear dysplasia, patella alta. We may wonder how dysplastic, how abnormal is the MPFL on patients with patellar instability.

Elvire Servien, MD, PhD

Knee & Shoulder Surgery

FIFA Medical Center of Excellence

Hopital de la Croix-Rousse - Lyon University

Centre Albert Trillat, Department of Orthopaedic Surgery

Lyon, France

Disclosures: Servien reports no relevant financial disclosures.