Kikuchi Shuhei, Tajima Goro, Yan Jun, Kamei Youichi, Maruyama Moritaka, Sugawara Atsushi, Fujino Kotaro, Takeda Sanjuro, Doita Minoru
Department of Orthopaedic Surgery, Iwate Medical University, 19-1 Uchimaru, Morioka, Iwate, 020-8505, Japan.
Department of Anatomy, Iwate Medical University, Morioka, Japan.
Knee Surg Sports Traumatol Arthrosc. 2017 Aug;25(8):2488-2493. doi: 10.1007/s00167-015-3973-1. Epub 2016 Jan 7.
The purpose of this study was to clarify the insertion sites on the patellar side of the medial patellofemoral ligament (MPFL).
A total of 35 nonpaired human cadaveric knees were used in this study. After identification of the MPFL, the insertion sites on the patellar side of the MPFL were marked. Three-dimensional images were created, and the location and morphology of these insertion sites were analysed.
The morphology of the insertion sites on the patellar side of the MPFL was consistent. The proximal fibres of the MPFL were inserted to the deep fascia of the vastus medialis obliquus (VMO) and medial margin of the vastus intermedius (VI). The distal fibres of the MPFL were inserted to the medial margin of the patella directly. The insertion lengths of the VMO, VI, and patella were 26.7 ± 5.0, 28.5 ± 4.4, and 18.5 ± 4.4 mm, respectively. The rate of the vertical distance from the superior pole of the patella to the superior edge of the MPFL in relation to the total patellar height was 12 ± 4.4 %. At the distal edge, the rate was 58 ± 9.6 %.
The insertion sites on the patellar side of the MPFL were consistent. The MPFL inserted into the VMO and VI was significantly longer than into the patella. The clinical relevance of this study is to improve understanding of the anatomy of the insertion sites on the patellar side of the MPFL and the pathophysiology of patellar dislocation.
本研究旨在明确髌股内侧韧带(MPFL)在髌骨侧的附着部位。
本研究共使用了35例非配对的人体尸体膝关节。在识别出MPFL后,标记其在髌骨侧的附着部位。创建三维图像,并分析这些附着部位的位置和形态。
MPFL在髌骨侧的附着部位形态一致。MPFL的近端纤维附着于股内侧斜肌(VMO)的深筋膜和股中间肌(VI)的内侧缘。MPFL的远端纤维直接附着于髌骨的内侧缘。VMO、VI和髌骨的附着长度分别为26.7±5.0、28.5±4.4和18.5±4.4mm。从髌骨上极到MPFL上缘的垂直距离与髌骨总高度的比值为12±4.4%。在远端边缘,该比值为58±9.6%。
MPFL在髌骨侧的附着部位一致。MPFL附着于VMO和VI的长度明显长于附着于髌骨的长度。本研究的临床意义在于提高对MPFL在髌骨侧附着部位解剖结构及髌骨脱位病理生理学的认识。