Anatomy and Function of the Proximal Medial Patellar Restraints

Background: The proximal medial patellar restraints, primarily the medial patellofemoral ligament (MPFL) and the medial quadriceps tendon-femoral ligament (MQTFL), play a crucial role in maintaining patellar stability during knee movements. The MPFL is essential for restraining lateral displacement of the patella, especially during the initial ۳۰ degrees of knee flexion. Understanding the anatomy and function of these ligaments is vital for diagnosing and treating patellar instability, which can lead to recurrent dislocations and associated complications. Methods: This study provides a comprehensive review of the anatomy and biomechanical functions of the MPFL and MQTFL, integrating findings from anatomical studies, clinical observations, and surgical outcomes from ۲۰۱۰ to ۲۰۲۲ to offer an updated overview of these structures. The review also includes an in-depth examination of their origins, insertions, and functional roles in knee stability, along with the outcomes of surgical interventions in cases of patellar instability. Results: The MPFL originates from the internal femoral condyle and attaches to the superomedial aspect of the patella, generating approximately ۵۰-۸۰% of the restraining force against lateral displacement. It is particularly active during early knee flexion (۰-۳۰ degrees), where it helps maintain proper patellar tracking within the trochlear groove. The MQTFL, extending from the quadriceps tendon to the femur, also aids patellar stability by reinforcing the medial restraint. Injuries to these ligaments are common in athletes, especially during activities that involve twisting or rotational movements. Clinical evidence indicates that MPFL injuries occur in over ۹۰% of acute lateral patellar dislocations, and if not properly addressed, there is a significant risk of recurrence. Additionally, surgical techniques such as MPFL reconstruction have shown promising results in restoring stability and reducing the risk of future dislocations. Conclusion: Consequently, a comprehensive understanding of the anatomy and function of the proximal medial patellar restraints is essential for the effective management of patellar instability. The MPFL and MQTFL are critical for maintaining knee stability, especially during dynamic movements. Given their importance, targeted surgical interventions can significantly improve outcomes for patients with recurrent dislocations. Future research should focus on refining surgical techniques and exploring non-surgical management options to enhance patient recovery. Keywords: Medial Patellofemoral Ligament (MPFL), Medial Quadriceps Tendon Femoral Ligament (MQTFL), Patellar stability, Knee flexion, Lateral displacement.

کلیدواژه ها:

Medial Patellofemoral Ligament (MPFL) ، Medial Quadriceps Tendon Femoral Ligament (MQTFL) ، Patellar stability ، Knee flexion ، Lateral displacement