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📌Tear of patellar side of the medial retinaculum
- All "partial" ruptures of the medial retinaculum originate inferomedially on the patella
- The location of the medial retinacular injury at the inferomedial patella anatomically corresponds to the insertion of the medial patellotibial ligament (MPTL), with or without bony avulsion
✅ Injury Patterns:
- There is a high incidence of both MPFL and chondral injury centered at the inferomedial aspect of the patella.[1]
- Partial MPFL ruptures often involve the inferomedial patella region, corresponding to the MPTL insertion site.[1]
- Complete MPFL tears extend proximally into the typical MPFL patellar insertion region.[1]
✅ Anatomical Relationships:
- The MPML and MPTL extend from the inferomedial patella to the medial meniscus and anteromedial tibia, respectively.[2]
- The MPML and MPTL are in close proximity to the patellar tendon and patellar articular cartilage.[3]
✅ Functional Significance:
- Although considered secondary stabilizers, the MPML and MPTL contribute substantially to preventing lateral patellar translation, tilt, and rotation during knee flexion.[2]
- Injury to the MPML and MPTL may lead to patellar instability, particularly when the trochlear sulcus is shallow.[3]
- MPTL reconstruction is increasingly being performed in conjunction with MPFL reconstruction for cases of patellar instability.[2]
- Isolated MPML injury may not cause significant symptomatic knee dysfunction, but its role in patellar instability needs further investigation.[3]
References:
[1] Knee Surg Sports Traumatol Arthrosc. 2018 Mar;26(3):677-684
[2] Radiographics. 2023 Jun;43(6):e220177
[3] Am J Sports Med. 2018 Jan;46(1):153-162
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#MPFL #MPTL #MedialRetinaculum #PatellarInstability #KneeInjuries #Orthopedics #SportsMedicine #MRI #PatellarDislocation #LigamentReconstruction
