From the Guidelines
The medial patellar retinaculum is a structure that can be assessed by MRI to evaluate its integrity, particularly in cases of prior or chronic patellar dislocation-relocation, and its injury treatment typically involves evaluating the extent of cartilage injury and identifying loose bodies 1.
Key Points
- The medial patellar retinaculum is a ligament that connects the patella to the medial aspect of the femur and tibia, playing a crucial role in maintaining patellar stability.
- Injury to the medial patellar retinaculum can occur due to patellar dislocation or other traumatic events, leading to chronic knee pain and instability.
- MRI is a useful diagnostic tool for evaluating the integrity of the medial patellar retinaculum, as well as assessing cartilage injury and identifying loose bodies 1.
- Treatment for medial patellar retinaculum injury typically involves a combination of conservative management, such as physical therapy and bracing, and surgical intervention, such as ligament reconstruction or patellar realignment procedures.
Diagnostic Evaluation
- MRI without IV contrast may be indicated when radiographs demonstrate a small osseous fragment along the medial patellar margin or if there is a clinical concern for prior or chronic patellar dislocation-relocation 1.
- MRI can assess the integrity of the medial patellofemoral ligament and medial patellar retinaculum, define the extent of cartilage injury, and identify loose bodies 1.
From the Research
Medial Patellar Retinaculum
- The medial patellar retinaculum is a ligamentous structure that plays a crucial role in maintaining patellar stability 2, 3.
- It is often injured in cases of patellar dislocation, which can lead to chronic instability and pain 4, 5.
Injury Treatment
- Various surgical techniques have been described to repair or reconstruct the medial patellar retinaculum, including primary repair, reefing, and imbrication 2, 4, 3.
- Medial retinacular plication with a needle-hole technique is a minimally invasive arthroscopic procedure that can correct patellar instability without requiring tissue grafts 6.
- Medial patella retinaculum plasty is a surgical technique that can restore both static and dynamic stability in adolescents with habitual patellar dislocation 5.
- The choice of treatment depends on the severity and pattern of the injury, as well as the presence of any associated pathology 4, 3.
Surgical Techniques
- A new minimally invasive surgical technique for medial retinaculum repair following traumatic patellar dislocation has been introduced, which achieves reinforced reattachment of the torn region of the medial retinaculum 2.
- Medial patellofemoral ligament repair is best indicated in the acute setting, particularly if there is a patella- or femoral-based avulsion 4.
- Arthroscopic medial retinacular plication with a needle-hole technique is a less invasive procedure that can be performed without tissue grafts, offering a greater cosmetic advantage than open procedures 6.