LO SCALPELLO-OTODI Educational

, Volume 30, Issue 2, pp 86–91 | Cite as

Nuovi principi di anatomia e biomeccanica della femoro-rotulea

  • Stefano Zaffagnini
  • Alberto Grassi
  • Marco Rotini
  • Federico Raggi
  • Tommaso Roberti di Sarsina
Aggiornamenti
  • 123 Downloads

Patellofemoral anatomy and biomechanics: current concepts

Abstract

The medial patellofemoral ligament (MPFL) has been demonstrated to contribute to 60 % of the force that opposes lateral displacement of the patella. Recent years have seen a growing interest in the study of this important anatomical structure, which acts as a restraint during motion, playing an active role under conditions of laterally applied stress, but an only marginal role during natural knee flexion. However, it remains extremely difficult to clearly define the anatomy of the MPFL and its relationships with other anatomical structures.

Notes

Conflitto di interesse

Gli autori Stefano Zaffagnini, Alberto Grassi, Marco Rotini, Federico Raggi e Tommaso Roberti di Sarsina dichiarano di non avere alcun conflitto di interesse.

Consenso informato e conformità agli standard etici

Tutte le procedure descritte nello studio e che hanno coinvolto esseri umani sono state attuate in conformità alle norme etiche stabilite dalla dichiarazione di Helsinki del 1975 e successive modifiche. Il consenso informato è stato ottenuto da tutti i pazienti inclusi nello studio.

Human and Animal Rights

L’articolo non contiene alcuno studio eseguito su esseri umani e su animali da parte degli autori.

Bibliografia

  1. 1.
    Amis AA, Senavongse W, Bull AM (2006) Patellofemoral kinematics during knee flexion-extension: an in vitro study. J Orthop Res 24:2201–2211 CrossRefPubMedGoogle Scholar
  2. 2.
    Insall J, Goldberg V, Salvati E (1972) Recurrent dislocation and the high-riding patella. Clin Orthop Relat Res 88:67–69 CrossRefPubMedGoogle Scholar
  3. 3.
    Blackburne JS, Peel TE (1977) A new method of measuring patellar height. J Bone Jt Surg 59:241–242 Google Scholar
  4. 4.
    Luyckx T, Didden K, Vandenneucker H et al. (2009) Is there a biomechanical explanation for anterior knee pain in patients with patella alta? Influence of patellar height on patellofemoral contact force, contact area and contact pressure. J Bone Jt Surg, Br Vol 91:344–350 CrossRefGoogle Scholar
  5. 5.
    Smillie IS (1974) The biomechanical basis of osteoarthritis of the knee in total knee replacement. Paper presented at “Total knee replacement” organised by the Institution of Mechanical Engineering, London Google Scholar
  6. 6.
    Takai S, Sakakida K, Yamashita F et al. (1985) Rotational alignment of the lower limb in osteoarthritis of the knee. Int Orthop 9:209–215 CrossRefPubMedGoogle Scholar
  7. 7.
    Weber U (1977) Malrotation of distal femur. Z Orthop Ihre Grenzgeb 115:707–715 (author’s transl) PubMedGoogle Scholar
  8. 8.
    Coscia PL, Fenoglio E, Cerlon C et al. (1983) Fisiopatologia delle lesioni degenerative del ginocchio nei vizi di torsione tibiale. Minerva Orthop 34:497–504 Google Scholar
  9. 9.
    Ficat P, Hungerford DS (1977) Disorders of the patellofemoral joint. Williams & Wilkins, Baltimore Google Scholar
  10. 10.
    Terry GC, Hughston JC, Norwood LA (1986) The anatomy of the iliopatellar band and iliotibial tract. Am J Sports Med 14:39–45 CrossRefPubMedGoogle Scholar
  11. 11.
    Insall J (1982) Current concepts review: patellar pain. J Bone Jt Surg, Am Vol 64:147–152 CrossRefGoogle Scholar
  12. 12.
    Fox TA (1975) Dysplasia of the quadriceps mechanism: hypoplasia of the vastus medialis muscle as related to the hypermobile patella syndrome. Surg Clin North Am 55:199–226 CrossRefPubMedGoogle Scholar
  13. 13.
    Farahmand F, Senavongse W, Amis AA (1998) Quantitative study of the quadriceps muscles and trochlear groove geometry related to instability of the patellofemoral joint. J Orthop Res 16:36–143 CrossRefGoogle Scholar
  14. 14.
    Goh JC, Lee PY, Bose K (1995) A cadaver study of the function of the oblique part of vastus medialis. J Bone Jt Surg, Br Vol 77:225–231 CrossRefGoogle Scholar
  15. 15.
    Voight ML, Wieder DL (1991) Comparative reflex response times of vastus medialis obliquus and vastus lateralis in normal subjects and subjects with extensor mechanism dysfunction. An electromyographic study. Am J Sports Med 19:131–137 CrossRefPubMedGoogle Scholar
  16. 16.
    Desio SM, Burks RT, Bachus KN (1998) Soft tissue restraints to lateral patellar translation in the human knee. Am J Sports Med 26:59–65 CrossRefPubMedGoogle Scholar
  17. 17.
    Senavongse W, Farahmand F, Jones J et al. (2003) Quantitative measurement of patellofemoral joint stability: force-displacement behavior of the human patella in vitro. J Orthop Res 21:780–786 CrossRefPubMedGoogle Scholar
  18. 18.
    Senavongse W, Amis AA (2005) The effects of articular, retinacular, or muscular deficiencies on patellofemoral joint stability: a biomechanical study in vitro. J Bone Jt Surg, Br Vol 87:577–582 CrossRefGoogle Scholar
  19. 19.
    Amis AA, Firer P, Mountney J et al. (2003) Anatomy and biomechanics of the medial patellofemoral ligament. Knee 10:215–220 CrossRefPubMedGoogle Scholar
  20. 20.
    Nomura E, Horiuchi Y, Kihara M (2000) Medial patellofemoral ligament restraint in lateral patellar translation and reconstruction. Knee 7:121–127 CrossRefPubMedGoogle Scholar
  21. 21.
    Philippot R, Chouteau J, Wegrzyn J et al. (2009) Medial patellofemoral ligament anatomy: implications for its surgical reconstruction. Knee Surg Sports Traumatol Arthrosc 17:475–479 CrossRefPubMedGoogle Scholar
  22. 22.
    Buckens CF, Saris DB (2010) Reconstruction of the medial patellofemoral ligament for treatment of patellofemoral instability: a systematic review. Am J Sports Med 38:181–188 CrossRefPubMedGoogle Scholar
  23. 23.
    Parker DA, Alexander JW, Conditt MA et al. (2008) Comparison of isometric and anatomic reconstruction of the medial patellofemoral ligament: a cadaveric study. Orthopedics 31:339–343 CrossRefPubMedGoogle Scholar
  24. 24.
    Ostermeier S, Stukenborg-Colsman C, Hurschler C et al. (2006) In vitro investigation of the effect of medial patellofemoral ligament reconstruction and medial tibial tuberosity transfer on lateral patellar stability. Arthroscopy 22:308–319 CrossRefPubMedGoogle Scholar
  25. 25.
    Ostermeier S, Holst M, Bohnsack M et al. (2007) In vitro measurement of patellar kinematics following reconstruction of the medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc 15:276–285 CrossRefPubMedGoogle Scholar
  26. 26.
    Sandmeier RH, Burks RT, Bachus KN et al. (2000) The effect of reconstruction of the medial patellofemoral ligament on patellar tracking. Am J Sports Med 28:345–349 CrossRefPubMedGoogle Scholar
  27. 27.
    Bedi H, Marzo J (2010) The biomechanics of medial patellofemoral ligament repair followed by lateral retinacular release. Am J Sports Med 38:1462–1467 CrossRefPubMedGoogle Scholar
  28. 28.
    Baldwin JL (2009) The anatomy of the medial patellofemoral ligament. Am J Sports Med 37:2355–2361 CrossRefPubMedGoogle Scholar
  29. 29.
    Nomura E, Inoue M, Osada N (2005) Anatomical analysis of the medial patellofemoral ligament of the knee, especially the femoral attachment. Knee Surg Sports Traumatol Arthrosc 13:510–515 CrossRefPubMedGoogle Scholar
  30. 30.
    Zaffagnini S, Colle F, Lopomo N et al. (2013) The influence of medial patellofemoral ligament on patellofemoral joint kinematics and patellar stability. Knee Surg Sports Traumatol Arthrosc 21(9):2164–2171 CrossRefPubMedGoogle Scholar
  31. 31.
    Smirk C, Morris H (2003) The anatomy and reconstruction of the medial patellofemoral ligament. Knee 10:221–227 CrossRefPubMedGoogle Scholar
  32. 32.
    Conlan T, Garth WP Jr, Lemons JE (1993) Evaluation of the medial soft-tissue restraints of the extensor mechanism of the knee. J Bone Jt Surg, Am Vol 75:682–693 CrossRefGoogle Scholar
  33. 33.
    Hautamaa PV, Fithian DC, Kaufman KR et al. (1998) Medial soft tissue restraints in lateral patellar instability and repair. Clin Orthop Relat Res 349:174–182 CrossRefGoogle Scholar
  34. 34.
    Panagiotopoulos E, Strzelczyk P, Herrmann M et al. (2006) Cadaveric study on static medial patellar stabilizers: the dynamizing role of the vastus medialis obliquus on medial patellofemoral ligament. Knee Surg Sports Traumatol Arthrosc 14:7–12 CrossRefPubMedGoogle Scholar
  35. 35.
    Thaunat M, Erasmus PJ (2007) The favourable anisometry: an original concept for medial patellofemoral ligament reconstruction. Knee 14:424–428 CrossRefPubMedGoogle Scholar
  36. 36.
    Wang F, Kang HJ, Chen BC et al. (2010) Combination of medial patellofemoral ligament reconstruction with vastus medialis advancement for chronic patellar dislocation. Chin Med J (Engl) 123:3024–3029 Google Scholar
  37. 37.
    Victor J, Wong P, Witvrouw E et al. (2009) How isometric are the medial patellofemoral, superficial medial collateral, and lateral collateral ligaments of the knee? Am J Sports Med 10:2028–2036 CrossRefGoogle Scholar
  38. 38.
    Nha KW, Papannagari R, Gill TJ et al. (2008) In vivo patellar tracking: clinical motions and patellofemoral indices. J Orthop Res 26:1067–1074 CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Yamada Y, Toritsuka Y, Horibe S et al. (2007) In vivo movement analysis of the patella using a three-dimensional computer model. J Bone Jt Surg, Br Vol 89:752–760 CrossRefGoogle Scholar
  40. 40.
    Amis AA (2007) Current concepts on anatomy and biomechanics of patellar stability. Sports Med Arthrosc 15:48–56 CrossRefPubMedGoogle Scholar
  41. 41.
    Brunet ME, Brinker MR, Cook SD et al. (2003) Patellar tracking during simulated quadriceps contraction. Clin Orthop Relat Res 414:266–275 CrossRefGoogle Scholar
  42. 42.
    Asano T, Akagi M, Koike K et al. (2003) In vivo three-dimensional patellar tracking on the femur. Clin Orthop Relat Res 413:222–232 CrossRefGoogle Scholar
  43. 43.
    Martelli S, Zaffagnini S, Bignozzi S et al. (2006) Validation of a new protocol for computer assisted evaluation of kinematics of double-bundle ACL reconstruction. Clin Biomech 21:279–287 CrossRefGoogle Scholar
  44. 44.
    Shih YF, Bull AM, Amis AA (2004) The cartilaginous and osseous geometry of the femoral trochlear groove. Knee Surg Sports Traumatol Arthrosc 12:300–306 CrossRefPubMedGoogle Scholar
  45. 45.
    Higuchi T, Arai Y, Takamiya H et al. (2010) An analysis of the medial patellofemoral ligament length change pattern using open-MRI. Knee Surg Sports Traumatol Arthrosc 18:1470–1475 CrossRefPubMedGoogle Scholar
  46. 46.
    Biedert RM, Netzer P, Gal I et al. (2011) The lateral condyle index: a new index for assessing the length of the lateral articular trochlea as predisposing factor for patellar instability. Int Orthop 35:1327–1331 CrossRefPubMedGoogle Scholar
  47. 47.
    Dejour H, Walch G, Nove-Josserand L et al. (1994) Factors of patellar instability: an anatomic radiographic study. Knee Surg Sports Traumatol Arthrosc 2:19–26 CrossRefPubMedGoogle Scholar
  48. 48.
    Yamada Y, Toritsuka Y, Yoshikawa H et al. (2007) Morphological analysis of the femoral trochlea in patients with recurrent dislocation of the patella using three-dimensional computer models. J Bone Jt Surg, Br Vol 89:746–751 CrossRefGoogle Scholar

Copyright information

© Società Italiana Ortopedici Traumatologi Ospedalieri d’Italia 2016

Authors and Affiliations

  • Stefano Zaffagnini
    • 1
  • Alberto Grassi
    • 1
  • Marco Rotini
    • 1
  • Federico Raggi
    • 1
  • Tommaso Roberti di Sarsina
    • 1
  1. 1.Clinica Ortopedica e Traumatologica II, Laboratorio di Biomeccanica ed Innovazione TecnologicaIstituto Ortopedico RizzoliBolognaItalia

Personalised recommendations