The proximal medial patellar retinaculum extends from the medial patellar border superiorly to the distal vastus medialis muscle fibres and the medial intermuscular septum. It is the superior component of the medial retinacular system and transmits vastus medialis oblique forces to the patella, contributing to active medial patellar stabilisation.
Transmits vastus medialis oblique force to the medial patella, contributing to active medial stabilisation and preventing lateral subluxation during early knee flexion.
The proximal medial retinaculum is torn in acute lateral patellar dislocation along with the medial patellofemoral ligament, but at a more proximal level. On MRI after first-time patellar dislocation, proximal medial retinacular disruption indicates VMO avulsion rather than MPFL femoral detachment. Proximal medial retinacular repair or advancement addresses recurrent patellar instability in combination with MPFL reconstruction.
Disruption at the vastus medialis-patellar junction during lateral patellar dislocation, producing medial patellar pain and swelling, visible as a proximal VMO avulsion pattern on MRI.
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