The medial patellotibial ligament connects the inferior medial patella to the medial proximal tibia, providing an inferior constraint on patellar position. It is the inferior component of the medial patellar retinaculum, working with the MPFL superiorly to maintain patellar centering. The MPTL is tightened by a valgus force on the patella and is assessed alongside the MPFL in patellar instability evaluation.
| Origin | Inferomedial border of the patella |
|---|---|
| Insertion | Anteromedial proximal tibia below the joint line, with some fibres to the anterior horn of the medial meniscus |
Acts as a secondary medial restraint to lateral patellar displacement, especially in deeper knee flexion
The MPTL is considered alongside the MPFL in patellar instability surgery. Some surgeons include MPTL reconstruction in addition to MPFL reconstruction for patients with inferior pole patellar instability patterns. MRI can identify MPTL disruption as medial tibial periosteal avulsion or mid-substance tearing.
MPTL disruption contributing to inferior patellar instability assessed alongside MPFL tears on MRI in recurrent dislocation evaluation.
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