Medial patellofemoral ligament is a part of the vastus medialis obliquus and vastus intermedius aponeuroses attaching to the medial epicondyle.

Adductor tubercle Aponeurosis Cortical bone thickness Joint capsule Medial epicondyle Medial patellofemoral ligament Vastus intermedius Vastus medialis obliquus

Journal

Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
ISSN: 1433-7347
Titre abrégé: Knee Surg Sports Traumatol Arthrosc
Pays: Germany
ID NLM: 9314730

Informations de publication

Date de publication:
Nov 2022
Historique:
received: 12 11 2021
accepted: 11 04 2022
pubmed: 7 5 2022
medline: 19 10 2022
entrez: 6 5 2022
Statut: ppublish

Résumé

This study aimed to investigate the bony surface characteristic of the femoral attachment of the medial patellofemoral ligament (MPFL) and the correlation between the relevant layered structures, including muscular aponeurosis and the joint capsule, which contribute to patellofemoral joint (PFJ) stability. The morphology of the medial aspect of the medial condyle using micro-computed tomography and analysed cortical bone thickening in 24 knees was observed. For the macroscopic and histological analyses, 21 and 3 knees were allocated, respectively. The Kruskal-Wallis one-way analysis of variance test with Dunn post hoc testing was performed for statistical analysis. At the level of the adductor tubercle, there were no significant differences in cortical bone thickness. At the level of the medial epicondyle (MEC), cortical bone thickness was considerably greater than that in other areas of the medial condyle (mean ± standard deviation, 0.60 ± 0.20 mm; p < 0.0001). Macroscopic analysis revealed that the deep aponeurosis of the vastus medialis obliquus and the tendinous arch of the vastus intermedius distally formed the composite membrane and adjoined to the joint capsule to firmly attach to MEC, which was located at 41.3 ± 5.7 mm posterior and 14.2 ± 3.1 mm superior to the joint cartilage. Histological analysis showed a composite membrane and adjoining capsule attached to MEC via fibrocartilage. MPFL could be interpreted as part of the deep aponeurosis of the vastus medialis obliquus (VMO) and the tendinous arch of the vastus intermedius, which combined with the joint capsule to attach to MEC. The cortical bone thickening indicated that the tensile stresses were loaded on MEC in aged cadavers. Involvement of VMO and vastus intermedius aponeuroses in restored graft of MPFL could utilise the dynamic stability of surrounding muscles to mimic a native structure.

Identifiants

pubmed: 35523877
doi: 10.1007/s00167-022-06984-7
pii: 10.1007/s00167-022-06984-7
pmc: PMC9568457
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

3742-3750

Informations de copyright

© 2022. The Author(s).

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Auteurs

Suthasinee Tharnmanularp (S)

Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Akimoto Nimura (A)

Department of Functional Joint Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan. nimura.orj@tmd.ac.jp.

Masahiro Tsutsumi (M)

Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Inclusive Medical Science Research Institute, Morinomiya University of Medical Sciences, Osaka, Japan.

Mio Norose (M)

Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Sachiyuki Tsukada (S)

Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

Keiichi Akita (K)

Department of Clinical Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.

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