Concepts of the Distal Medial Patellar Restraints: Medial Patellotibial Ligament and Medial Patellomeniscal Ligament

Background: The distal internal patellar restraints, particularly the medial patellofemoral ligament (MPFL) and medial patellar ligament (MPTL), are essential components in maintaining patellar stability in the knee joint. These ligaments work in conjunction with other structures to prevent lateral dislocation of the patella, especially during dynamic activities. Understanding their anatomy and function is crucial for diagnosing and treating patellar instability, which can lead to recurrent dislocations and long-term joint issues. Methods: This updated review study presents the anatomy and biomechanical functions of the MPTL and MPFL, examining the existing literature from ۲۰۱۰ to ۲۰۲۳, including anatomical studies, clinical findings, and surgical outcomes related to these ligaments. The aim is to clarify their role in patellar stabilization and highlight the implications of surgical interventions in cases of patellar instability. Results: The MPTL originates from the inner aspect of the patella and extends to the tibia, providing significant resistance against lateral movement. It is particularly active during knee flexion, contributing around ۲۰-۳۰% of the total restraining force against lateral displacement. Conversely, the MPFL connects the medial meniscus to the patella, further enhancing internal stability. Both ligaments are vital during activities involving knee flexion and rotation. Injuries to these ligaments often occur in sports requiring sudden direction changes or jumps. Clinical evidence indicates that tears in these ligaments, if untreated, can increase the risk of recurrent dislocations. On the other hand, surgical reconstruction of these ligaments has shown promising results in restoring stability and reducing recurrence rates. Furthermore, studies indicate that early intervention can significantly improve patient outcomes, particularly in individuals with a history of multiple dislocations. Conclusion: Consequently, a comprehensive understanding of the distal internal patellar restraints—MPTL and MPFL—is critical for effectively managing patellar instability. These ligaments play a crucial role in stabilizing the patella during knee movements, especially in dynamic sports scenarios. Surgical interventions targeting these structures can significantly enhance stability and prevent future dislocations. Also, ongoing research is essential for refining surgical techniques and developing non-surgical management strategies for at-risk patients. Keywords: Medial Patellotibial Ligament (MPTL), Medial Patellomeniscal Ligament (MPML), Patellar stability, Lateral displacement, Knee flexion.

کلیدواژه ها:

Medial Patellotibial Ligament (MPTL) ، Medial Patellomeniscal Ligament (MPML) ، Patellar stability ، Lateral displacement ، Knee flexion