Summary: The purpose of this study was to perform systematic review and meta-analysis of the radiographic landmarks reported in the literature for the anatomic MPFLR femoral origin.

Introduction

Accurate femoral tunnel positioning for medial patellofemoral ligament reconstruction (MPFLR) is essential for maintaining ligament isometry throughout knee range of motion. Although it is accepted practice to utilize Schöttle’s point as a surrogate for the anatomic location of the MPFL, there may be considerable individual variability. The purpose of this study was to perform systematic review and meta-analysis of the radiographic landmarks reported in the literature for the anatomic MPFLR femoral origin.

Methods

A meta-analysis was performed of the PubMed, EMBASE, and Cochrane Library databases to identify studies that reported the radiographic position of the MPFLR femoral tunnel position. Included studies were required to report the position of the MPFLR femoral tunnel relative to the posterior cortical extension line (PCEL) in the anterior-posterior direction and to either Blumensaat’s line or another radiographic landmark in the proximal-distal direction. Studies that reported the location of MPFLR femoral tunnel relative to anatomical landmarks, such as the adductor tubercle or medial epicondyle, were excluded. Microsoft Excel was used to calculate weighted means and standard deviations.

Results

Seven studies were included, ranging in publication date from 2007 to 2022. A total of 75 cadaveric knees were analyzed with a mean age of 62.9 ±12.4 years. The average distance from the PCEL to the MPFLR femoral tunnel was 2.24 ± 4.66 mm anterior [95% CI: 1.19, 3.30], with individual studies reporting a range from 4.80 mm posterior to 8.80 mm anterior to the PCEL.

The average distance from Blumensaat’s line to the MPFLR femoral tunnel was 1.36 ± 2.11 mm proximal [95% CI: 0.86, 1.87], ranging from 0.90 mm distal to 4.70 mm proximal to Blumensaat’s. Two studies reported the mean distance from the condylar transition line, averaging 1.35 ± 0.30 mm distal [95% CI: 1.20, 1.50], ranging from 5.70 mm distal to 2.50 mm distal to the condylar transition line.

Conclusion

This meta-analysis highlights the substantial heterogeneity in the radiographic location of the anatomic origin of the MPFLR relative to the PCEL and Blumensaat’s line. The findings underscore the importance of integrating radiographic data with intraoperative (i.e. osseous anatomic) landmarks to enhance precision of tunnel placement and optimize graft isometry. Further studies are needed to refine these radiographic landmarks and explore their relationship with functional outcomes following MPFLR.

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Your Patella Dislocated: Will It Happen Again? An Assessment Of Mri Criteria For Recurrent Patella Dislocation After An Initial Event ePoster Presentation Mauricio Drummond, Jr., MD, UNITED STATES Jason Brenner, MS, UNITED STATES Steven Henick, MD, UNITED STATES Leila M. Alvandi, PhD, UNITED STATES Edina Gjonbalaj, BS, UNITED STATES Benjamin Levy, UNITED STATES Jacob Schulz, UNITED STATES Eric D. Fornari, MD, UNITED STATES
Patellar Tendon To Lateral Trochlear Ridge (PT-LTR) as an Indicator of Patellar Instability With Malalignment ePoster Presentation Brittany Margaret Ammerman, MD, MBS, UNITED STATES Ryann Davie, MD, UNITED STATES Natalie K. Pahapill, BS, UNITED STATES Bennett Propp, BS, UNITED STATES Simone Gruber, MS, UNITED STATES Joseph T. Nguyen, MPH, UNITED STATES Audrey Christine Wimberly, MPH, UNITED STATES Michelle E. Kew, MD, UNITED STATES Elizabeth Rose Dennis, MD MS, UNITED STATES Beth Ellen Shubin Stein, MD, UNITED STATES
The Prevalence Of Associated Anatomical Risk Factors For Patellofemoral Joint Pathology In Patients Undergoing Rotational Osteotomy And The Implication For The Level Of Correction. ePoster Presentation Martyn Snow, FRCS, UNITED KINGDOM Gwithyen Silk, FRCS, MRCS, MBChB, BA (Hons), MA, UNITED KINGDOM Mohammad Mahmoud Mohammad Mahmoud Haikal, MBChB , MSc(Orth), EGYPT
Reporting Bias is Highly Prevalent in Systematic Reviews and Meta-Analyses of Medial Patellofemoral Ligament Reconstruction ePoster Presentation Kenneth T Nguyen, BS, UNITED STATES Erin L Brown, BA, UNITED STATES William C Rittmeyer, BS, UNITED STATES Mia Rumps, MS, UNITED STATES Mary K. Mulcahey, MD, UNITED STATES
An Oblique Transposition Quadricepsplasty Provides Excellent Outcomes For The Treatment Of Type Iv (Obligatory, Flexion-Range) Patellar Dislocation ePoster Presentation Philip Wilson, MD, UNITED STATES Clarissa Meza, MD, UNITED STATES Charles W. Wyatt, CPNP, UNITED STATES V. Claire Clark, BS, UNITED STATES Benjamin Johnson, PA-C, UNITED STATES Henry B. Ellis, MD, UNITED STATES
CLINICAL AD RADIOLOGICAL OUTCOMES AFTER ISOLATED MEDIAL PATELLOFEMORAL RECONSTRUCTION FOR RECURRENT PATELLAR DISLOCATION WITH COMPLETELY IMPLANT FREE TECHNIQUE AMONG POPULATION OF YOUNG SPORT PATIENTS ePoster Presentation Matteo Baldassarri, MD, ITALY Luca Perazzo, MD, ITALY Diego Ghinelli, ITALY Sarino Ricciardello, MD, ITALY Alessandro Parma, MD, ITALY Roberto Buda, Prof., ITALY
Initial Results from the Creation of a Normative Database for the Banff Patellar Instability Instrument ePoster Presentation Mark Lafave, PhD, CAT(C), CANADA Laurie A. Hiemstra, MD, PhD, FRCSC, CANADA Sarah Kerslake, BPhty, MSc, CANADA Daniel Stolear, MA, CANADA
How Should I Measure Proximal Femoral Version In Torsional Deformity? A New, Easy And Reproducible Measurement Method Using Maximum Intensity Projection (Mip) Imaging On Ct Scan. ePoster Presentation Federica Rosso, MD, ITALY Marco Bechis, ITALY Giorgio Governale, MD, ITALY Antonino Cantivalli, MD, ITALY Francesco Liberace, MD, ITALY Roberto Rossi, MD, ITALY Davide Bonasia, MD, ITALY
Increased TT-TG and Sulcus Angle are Associated with Patella Osteochondritis Dissecans ePoster Presentation Emilie Lijesen, BS, UNITED STATES Akshitha Adhiyaman, BS, UNITED STATES Olivia C. Tracey, BA, UNITED STATES Joshua T. Bram, MD, UNITED STATES Nnaoma M Oji, MD, UNITED STATES Danielle E. Chipman, BS, UNITED STATES Shae K Simpson, BS, UNITED STATES Douglas Mintz, MD, UNITED STATES Peter D. Fabricant, MD, MPH, UNITED STATES Daniel W. Green, MD, MS, UNITED STATES
Genetic Evidence Suggests Education Reduces Risk Of Patellar Dislocation: Insights From Mendelian Randomization ePoster Presentation Chao Zhang, CHINA Qian Wu, CHINA
Torsional Limb Deformities In Patients With Lateral Patellar Dislocation: An Expert Survey Of The International Patellofemoral Study Group. ePoster Presentation Guido Wierer, MD, AUSTRIA Danko Dan Milinkovic, MD, GERMANY Gerd Seitlinger, MD, AUSTRIA Michael C. Liebensteiner, MD, PhD, AUSTRIA William R. Post, MD, UNITED STATES Philipp Wilhelm Winkler, MD, Assoc. Prof., AUSTRIA
The Interaction of Race and Socioeconomic Deprivation in Treatment of Patellofemoral Instability: Data from the JUPITER Cohort ePoster Presentation Jacqueline M. Brady, MD, UNITED STATES Elizabeth Rose Dennis, MD MS, UNITED STATES Bennett Propp, BS, UNITED STATES Justin Hicks, UNITED STATES Heath Patrick Gould, MD, UNITED STATES Natalie K. Pahapill, BS, UNITED STATES Audrey Christine Wimberly, MPH, UNITED STATES Joseph T. Nguyen, MPH, UNITED STATES Matthew William Veerkamp, BA, UNITED STATES Eric J. Wall, MD, UNITED STATES Shital N. Parikh, MD, UNITED STATES Beth Ellen Shubin Stein, MD, UNITED STATES
Comparative Clinical and Radiographic Outcomes of Particulated Juvenile Articular Cartilage Implantation in Shouldered and Unshouldered Patella Cartilage Lesions ePoster Presentation Ryann Davie, MD, UNITED STATES Brittany Margaret Ammerman, MD, MBS, UNITED STATES Bennett Propp, BS, UNITED STATES Erick Marigi, MD, UNITED STATES William A. Marmor, MD, UNITED STATES Kiera A. Kingston, MD, UNITED STATES Natalie K. Pahapill, BS, UNITED STATES Alissa J. Burge, MD, UNITED STATES Audrey Christine Wimberly, MPH, UNITED STATES Joseph T. Nguyen, MPH, UNITED STATES Elizabeth Rose Dennis, MD MS, UNITED STATES Beth Ellen Shubin Stein, MD, UNITED STATES
3D-Pass (3D Patellar Instability Anatomical Severity Score): A Novel Metric Using Machine Learning To Predict Treatment Outcome In Patella Instability ePoster Presentation Marissa Lee Sinopoli, PhD, UNITED STATES Anthony Gatti, PhD, UNITED STATES Christian E Wright, BS, UNITED STATES Anna Bartsch, MD, SWITZERLAND Matthew William Veerkamp, BA, UNITED STATES Akshay Chaudhari, PhD, UNITED STATES Beth Ellen Shubin Stein, MD, UNITED STATES Shital N. Parikh, MD, UNITED STATES Kevin G. Shea, MD, UNITED STATES Scott Delp, PhD, UNITED STATES Seth L. Sherman, MD, UNITED STATES The JUPITER Group, UNITED STATES

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Radiographic Landmarks Of Medial Patellofemoral Ligament Reconstruction: A Systematic Review And Meta-Analysis Of Femoral Tunnel Position

Radiographic Landmarks Of Medial Patellofemoral Ligament Reconstruction: A Systematic Review And Meta-Analysis Of Femoral Tunnel Position

Introduction

Methods

Results

Conclusion

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Radiographic Landmarks Of Medial Patellofemoral Ligament Reconstruction: A Systematic Review And Meta-Analysis Of Femoral Tunnel Position

Radiographic Landmarks Of Medial Patellofemoral Ligament Reconstruction: A Systematic Review And Meta-Analysis Of Femoral Tunnel Position

Introduction

Methods

Results

Conclusion