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📌 Anatomy of the Medial Patellotibial Ligament (MPTL)
✅ Tibial Insertion
- Recent studies show the tibial insertion of the MPTL is closer to the joint line than previously thought, only 5mm distal on plain radiographs (vs 10-20mm reported earlier).[1]
- A new anatomical landmark - the "medial tibial tubercle" - has been identified as a readily palpable bony ridge corresponding to the MPTL's tibial attachment site.[1]
✅ Patellar Insertion
- The MPTL inserts into the distal-medial patella 3.6mm proximal to the distal border, so its patellar attachment is mostly near the distal pole.[2]
✅ Surgical Considerations
- Due to the close proximity of MPTL attachments to articular cartilage, MPTL reconstructions based solely on surface landmarks risk cartilage violation.[1]
- Arthroscopic guidance is recommended to ensure safe MPTL reconstruction without damaging patellofemoral or tibiofemoral joint cartilage.[1]
Understanding the accurate anatomy of the MPTL and its attachment sites is crucial when performing surgical procedures involving this ligament.
References:
[1] Frantz TL, Paronen JM, Brethauer SA, et al. Anatomy of the medial patellotibial ligament revisited. Am J Sports Med. 2018;46(1):153-162.
[2] Ford AT, Fenwick AM, Parsons N, et al. Precise insertion of the medial patellotibial ligament: An arthroscopic and radiographic study. Arthroscopy. 2020;36(3):923-930.
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#MedicalPatellotibialLigament, #KneeAnatomyLandmarks, #TibialInsertion, #PatellarInsertion, #MedialTibialTubercle, #MPTLReconstruction, #ArthroscopyGuidance, #KneeCartilagePreservation, #SurgicalAnatomyKnowledge, #OrthopaedicSurgery
