Anatomical study of the lateral patellofemoral ligament in cadaver knees

OBJECTIVES: To describe the lateral patellofemoral ligament (LPFL) after anatomical dissection of fresh cadaver knees. The literature shows a particular interest for the LPFL. Such special attention is due to its anatomical and biomechanical importance, and also due to the need to reconstruct the ligament in the cases of medial patellar instability. METHODS: The LPFL was studied in 20 knees of 20 fresh cadavers by means of anatomical dissections. The dissections were standardized and the data were noted down and forwarded to statistical analysis. RESULTS: The LPFL presented a mean 16.05 mm width (standard deviation of 2.48), 42.10 mm length (standard deviation of 8.84). The femoral insertion was found at the lateral femoral epicondyle and with a fan-like expansion of the fibers, predominantly in the posterior region proximal to the lateral epicondyle. In the patella, the insertion found was in the upper-lateral region (in the middle of the upper third of the coronal plan), also with expanded fibers, but less intensely so. In the sagittal plan, the ligament was located in the posterior half of the border of the patella. The LPFL was isolated in the second lateral retinacular layer, the deep transverse retinaculum. CONCLUSION: The LPFL is located in the deep transverse retinacular layer with the presence of a fan-like expansion of its fibers both in the femoral and in the patellar insertions. The insertion is more posterior and proximal at the femoral epicondyle and in the posterior half of the patellar border (sagittal plan) and in the upper-lateral aspect.OBJETIVOS: Descrever o ligamento patelofemoral lateral (LPFL) por meio de dissecação anatômica de joelhos de cadáveres frescos. Na literatura existe particular interesse pelo LPFL. Essa especial atenção é dada pela sua importância anatômica, biomecânica e pela necessidade da sua reconstrução nos casos de instabilidade medial da patela. MÉTODOS: O LPFL foi estudado em 20 joelhos de 20 cadáveres frescos por meio de dissecações anatômicas. As dissecações foram padronizadas e os dados anotados enviados para análise estatística. RESULTADOS: O LPFL apresentou em média 16,05mm de largura (desvio-padrão: 2,48), 42,10mm de comprimento (desvio-padrão: 8,84). Sua inserção femoral mostrou-se no epicôndilo femoral lateral e com expansão em forma de leque das suas fibras, predominantemente na região posterior e proximal ao epicôndilo lateral. Na patela a inserção encontrada foi na região súpero-lateral (na metade do terço superior no plano coronal), também com expansão das fibras, mas com menor intensidade. No plano sagital, o ligamento situava-se na metade posterior da borda da patela. O LPFL foi isolado na segunda camada retinacular lateral, o retináculo transverso profundo. CONCLUSÃO: O LPFL situa-se na camada retinacular transversa profunda, com a presença de uma expansão das suas fibras em forma de leque, tanto na inserção femoral quanto na patelar. No epicôndilo femoral a inserção encontra-se mais posterior e proximalmente e na patela está na metade posterior da borda patelar (plano sagital) e no aspecto súpero-lateral.Faculdade de Medicina do ABC Grupo de Traumatologia Esportiva da Disciplina de OrtopediaUNIFESP Departamento de OrtopediaFaculdade de Medicina do ABCUNIFESP, Depto. de OrtopediaSciEL

Relação entre o ligamento patelofemoral lateral e a largura da faceta patelar lateral

Objective: The aim of this study, with cadavers, is to evaluate the relationship between the width and length of the lateral patellofemoral ligament (LPFL) and the size of the lateral patellar articular facet (LPAF). Patellofemoral instability is closely re ate to patellar morphology and the lateral retinacular layers. Studies evidence that the wider the lateral patellar facet and the more strained the lateral retinaculum, the greater the tendency for development of pathology in the patellofemoral joint. Methods: 20 knees were dissected in 20 cadavers. The parts were identified according to gender, age, dissected side, length and width of LPFL and width of LPAF In order to carry out the statistical analysis we adopted the significance level of 5% (0.050) and also used Spearman's Coefficient of Rank Correlation. Results: The LPFL presented a mean width of 16.05 millimeters (standard deviation 2.48) and 42.10 millimeters of length (standard deviation 8.84). The width of the LPAF varied from 23 to 37 millimeters (mean 28.1). It was observed that the relationship between the LPAF and LPFL widths is not statistically significant (p=0.271), whereas the relationship between the LPAF width and the LPFL length is statistically significant (p=0.009). Conclusion: The shorter the LPFL the greater the width of the LPAF.Fac Med ABC, Sports Traumatol Grp Orthoped & Traumatol, Santo Andre, SP, BrazilUniv Fed Sao Paulo, Dept Orthoped, Sao Paulo, BrazilUniv Fed Sao Paulo, Dept Orthoped, Sao Paulo, BrazilWeb of Scienc