The medial patellofemoral ligament is the primary passive restraint preventing lateral dislocation of the patella, providing approximately 50 to 60 percent of the total medial restraint force. It is injured in virtually every acute lateral patellar dislocation and is the primary target of surgical reconstruction in patients with recurrent patellar instability. Understanding its anatomy and biomechanics is fundamental to managing patellar dislocation.
| Origin | Medial femoral epicondyle between the adductor tubercle and the medial collateral ligament |
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| Insertion | Superomedial border of the patella |
| Actions | Primary restraint to lateral patellar displacement, providing 50 to 60 percent of medial patellar restraint |
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MPFL tears occur in almost all acute patellar dislocations and are confirmed on MRI. Conservative management with rehabilitation is appropriate for first-time dislocators without significant trochlear dysplasia. Patients with recurrent dislocations, trochlear dysplasia, high tibial tubercle to trochlear groove distance, or patella alta are candidates for MPFL reconstruction, often combined with tibial tubercle osteotomy depending on the underlying anatomy.
Virtually universal accompaniment to acute lateral patellar dislocation, confirmed on MRI, managed conservatively for first-time events and surgically reconstructed for recurrent instability.
