The morphological characteristics of the medial patellotibial ligament and its insertion sites using three-dimensional computed tomography: a cadaveric study

Abstract

To identify the insertion sites of the medial patellotibial ligament‹MPTL›, eighteen nonpaired human cadaveric knees were used in this study. The MPTL was clearly identified in 16 of 18 knees, and was a thin uniform band-like tissue appearing as a capsular ligament. The insertion site on the patella was located midway between the medial patellofemoral ligament and the patellar tendon and was in contact with the medial side of the patellar tendon. The ratio of the vertical distance from the superior pole of the patella to the superior end of the MPTL to the total patellar height was 70.1 ± 3.3% at the proximal end. At the distal end, the ratio was 84.2± 3.5%. The insertion site on the tibia was 16.2 ± 2.5 mm distal to the tibial anterior edge, which was 21.4 ± 2.9 mm proximal to the medial aspect of the tibial tuberosity groove in which the proximal pes anserinus attached. We clarified the MPTL insertion sites on both the patellar and tibial sides. The clinical relevance of this study is that understanding the anatomy of the MPTL was improved, and our findings may assist surgeons in performing successful reconstruction of the MPTL.