(Fig 4-A.32) Type P0/ Ligament Disruption at Patellar Attachment

https://youtu.be/I-vLqY-f24k

https://youtu.be/vzxclU_34OI?si=B88NykUJHSELzyAC

 

 

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📌 Ligament Disruption at Patellar Attachment

• The patellar insertion is wider and reinforced by surrounding tendons and retinacula.
• Ruptures at this site or the MPFL midsubstance without avulsion fragment are generally not associated with significant patellar instability. (Reference: Knee Surg Sports Traumatol Arthrosc (2014) 22:2414–2418)

✅Femoral MPFL Attachment

• The femoral attachment is the weakest part of the MPFL.
• The patellar insertion is much wider and reinforced by the tendon of the vastus medialis obliquus muscle, medial retinaculum, and the vastus intermedius tendon. (Reference: Knee Surg Sports Traumatol Arthrosc. 2019 Jan;27(1):197-205)

 

✅ Transverse Component of the MPFL

• The femoral attachment of the tMPFL is assessed immediately below the adductor tubercle and above the superior attachment of the sMCL.
• It is very thin and difficult to visualize even in the uninjured state.
• Readers characterized this femoral attachment as "no edema" or "edema" rather than using a grading system. (Reference: Skeletal Radiology (2022) 51:1381–1389)

 

✅Case MRI Findings

• Ligamentous partial disruption at the patellar attachment
• Bone marrow contusions at the medial patellar facet
• No bony avulsion fracture from the medial patella
• Edema noted at the femoral attachment of the MPFL, indicating a partial tear of the femoral MPFL component.

 

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#MPFLinjury, #PatellarAvulsion, #FemoralAttachment, #BoneMarrowContusion, #LigamentDisruption, #PatellarInstability, #MPFLTear, #MRIFindings, #OrthopaedicSurgery, #SportsMedicine