Patellofemoral Anatomy and Its Surgical Implications

Several structures serve as primary static restraints to lateral and medial patellar displacement. Current evidence has demonstrated that there is a complex of ligaments both proximal (with corresponding attachments in the femur (medial patellofemoral ligament (MPFL) and medial quadriceps tendon femoral ligament (MQTFL)) and distal (medial patellotibial ligament (MPTL) and the medial patellomeniscal ligament (MPML)) that restrain lateral patellar translation at different degrees of knee flexion. Similarly, descriptions of proximal lateral restraints (with corresponding attachments on the femur (lateral patellofemoral ligament (LPFL)) and distal lateral restraints (lateral patellotibial ligament (LPTL) and lateral patellomeniscal ligament (LPML)) that restrain medial patellar translation have been described. Anatomical knowledge of these structures is of utmost importance for the diagnosis and treatment of these injuries. The purpose of this chapter is to report on the anatomical and surgical implications of the patellar restraints.