A polygon‐shaped complex appearance of medial patellofemoral ligament with dynamic functional insertion based on an outside‐in and inside‐out dissection technique

Yunshen Ge, Shiyi Chen, Tomohiro Kato, Urszula Zdanowicz, Robert Smigielski

To describe the unclarified characteristics of medial patellofemoral ligament and its relation to neighboring structures. Sixteen fresh-frozen human knees were dissected in using outside-in and inside-out combined technique. The patellar side attachment was observed from the inside view and femoral side from outside view. The medial patellofemoral ligament was described a complex and multiconnected structure. The femoral side included the upper and lower portion, of which the upper portion attached on the femur with mean width 7.5 ± 1.1 mm and its superficial fibers extended to the adductor magnus tendon and the medial gastrocnemius tendon, and of which the lower portion appeared a right-triangle connected to the MCL without bony attachment. From inside view, the patellar attachment consisted of the bony and non-bony parts. The width of bony attachment was measured mean 16.3 ± 3.8 mm, and the non-bony attachment was found attached on the vastus intermedius tendon with mean width 21.7 ± 4.8 mm. The average thickness was 0.4 ± 0.1 mm and the length were inside assessed mean 67.9 ± 6.1 mm. The medial patellofemoral ligament which dissected a complicated structure with bony and non-bony attachment and multi-connected to neighboring structures on both patella and femur side appears as a polygon-shaped complex structure.