The medial femoral epicondyle is the most medially prominent bony landmark of the distal femur, providing attachment for the superficial MCL, the medial gastrocnemius head, and the posterior oblique ligament. The adductor tubercle lies just proximal to it, marking the distal attachment of adductor magnus.
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| Ossification | Medial femoral epiphysis fuses at age 16-18 years, incorporating the epicondylar region. |
The medial femoral epicondyle is the proximal attachment of the medial patellofemoral ligament (MPFL), which is the primary patellar stabiliser. MPFL reconstruction grafts are anchored at the medial epicondyle using bone tunnels or suture anchors. The medial epicondyle is the reference point for medial knee approach and for MCL reconstruction. Avulsion of the medial epicondyle occurs in high-energy valgus knee injuries.
Bend the knee to about 90 degrees and feel on the inner side of the lower femur for its most prominent bony point; this is the medial epicondyle. The adductor tubercle lies just above and behind it, and the medial collateral ligament starts here.
Valgus stress injures the medial collateral ligament at or near its femoral origin on the epicondyle.
Calcification at the MCL origin near the medial epicondyle after an old ligament injury.
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