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High resolution magnetic resonance imaging of the patellar retinaculum: normal anatomy, common injury patterns, and pathologies

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Abstract

The medial patellar retinaculum (MPR) and the lateral patellar retinaculum (LPR) are vital structures for the stability of the patella. Failure to identify or treat injury to the patellar retinaculum is associated with recurrent patellar instability and contributes to significant morbidity. High-resolution magnetic resonance imaging (MRI) readily depicts the detailed anatomy of various components (layers) of the retinacula. In this review article, we discuss normal anatomy, important landmarks, common injury patterns, and other pathologies encountered in patellar retinacula. High field strength MRI is an excellent noninvasive tool for evaluation of patellar retinaculum anatomy and pathology. This article will help the reader become familiar with normal imaging findings and the most commonly occurring injuries/pathologies in MPR and LPR.

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References

  1. Baldwin JL. The anatomy of the medial patellofemoral ligament. Am J Sports Med. 2009;37(12):2355–61.

    Article  PubMed  Google Scholar 

  2. Merican AM, Amis AA. Anatomy of the lateral retinaculum of the knee. J Bone Joint Surg Br. 2008;90(4):527–34.

    Article  PubMed  CAS  Google Scholar 

  3. Merican AM, Sanghavi S, Iranpour F, Amis AA. The structural properties of the lateral retinaculum and capsular complex of the knee. J Biomech. 2009;42(14):2323–9.

    Article  PubMed  Google Scholar 

  4. Amis AA, Firer P, Mountney J, Senavongse W, Thomas NP. Anatomy and biomechanics of the medial patellofemoral ligament. Knee 2003;10(3):215–20.

    Google Scholar 

  5. De Maeseneer M, Van Roy F, Lenchik L, Barbaix E, De Ridder F, Osteaux M. Three layers of the medial capsular and supporting structures of the knee: MR imaging-anatomic correlation. Radiographics. 2000;20 Spec No:S83–9.

    Google Scholar 

  6. Warren LF, Marshall JL. The supporting structures and layers on the medial side of the knee: an anatomical analysis. J Bone Joint Surg Am. 1979;61(1):56–62.

    PubMed  CAS  Google Scholar 

  7. Tuxoe JI, Teir M, Winge S, Nielsen PL. The medial patellofemoral ligament: a dissection study. Knee Surg Sports Traumatol Arthrosc. 2002;10(3):138–40.

    Article  PubMed  Google Scholar 

  8. Starok M, Lenchik L, Trudell D, Resnick D. Normal patellar retinaculum: MR and sonographic imaging with cadaveric correlation. AJR Am J Roentgenol. 1997;168(6):1493–9.

    PubMed  CAS  Google Scholar 

  9. Sanders TG, Morrison WB, Singleton BA, Miller MD, Cornum KG. Medial patellofemoral ligament injury following acute transient dislocation of the patella: MR findings with surgical correlation in 14 patients. J Comput Assist Tomogr. 2001;25(6):957–62.

    Google Scholar 

  10. Conlan T, Garth Jr WP, Lemons JE. Evaluation of the medial soft-tissue restraints of the extensor mechanism of the knee. J Bone Joint Surg Am. 1993;75(5):682–93.

    PubMed  CAS  Google Scholar 

  11. LaPrade RF, Engebretsen AH, Ly TV, Johansen S, Wentorf FA, Engebretsen L. The anatomy of the medial part of the knee. J Bone Joint Surg Am. 2007;89(9):2000–10.

    Article  PubMed  Google Scholar 

  12. Garth Jr WP, Connor GS, Futch L, Belarmino H. Patellar subluxation at terminal knee extension: isolated deficiency of the medial patellomeniscal ligament. J Bone Joint Surg Am. 2011;93(10):954–62.

    Article  PubMed  Google Scholar 

  13. Elias DA, White LM, Fithian DC. Acute lateral patellar dislocation at MR imaging: injury patterns of medial patellar soft-tissue restraints and osteochondral injuries of the inferomedial patella. Radiology. 2002;225(3):736–43.

    Google Scholar 

  14. Sanders TG, Paruchuri NB, Zlatkin MB. MRI of osteochondral defects of the lateral femoral condyle: incidence and pattern of injury after transient lateral dislocation of the patella. AJR Am J Roentgenol. 2006;187(5):1332–7.

    Article  PubMed  Google Scholar 

  15. Quinn SF, Brown TR, Demlow TA. MR imaging of patellar retinacular ligament injuries. J Magn Reson Imaging. 1993;3(6):843–7.

    Google Scholar 

  16. Diederichs G, Issever AS, Scheffler S. MR imaging of patellar instability: injury patterns and assessment of risk factors. Radiographics. 2010;30(4):961–81.

    Google Scholar 

  17. Sillanpaa PJ, Peltola E, Mattila VM, Kiuru M, Visuri T, Pihlajamaki H. Femoral avulsion of the medial patellofemoral ligament after primary traumatic patellar dislocation predicts subsequent instability in men: a mean 7-year nonoperative follow-up study. Am J Sports Med. 2009;37(8):1513–21.

    Article  PubMed  Google Scholar 

  18. Chhabra A, Subhawong TK, Carrino JA. A systematised MRI approach to evaluating the patellofemoral joint. Skeletal Radiol. 2011;40(4):375–87.

    Article  PubMed  Google Scholar 

  19. Chung CB, Skaf A, Roger B, Campos J, Stump X, Resnick D. Patellar tendon-lateral femoral condyle friction syndrome: MR imaging in 42 patients. Skeletal Radiol. 2001;30(12):694–7.

    Article  PubMed  CAS  Google Scholar 

  20. Miller PR, Klein RM, Teitge RA. Medial dislocation of the patella. Skeletal Radiol 1991;20(6):429–31.

    Google Scholar 

  21. Lemish W, Apsimon T, Chakera T. Lumbar intraspinal synovial cysts. Recognition and CT diagnosis. Spine (Phila Pa 1976) 1989;14(12):1378–83.

  22. Soren A. Pathogenesis, clinic, and treatment of ganglion. Arch Orthop Trauma Surg. 1982;99(4):247–52.

    Article  PubMed  CAS  Google Scholar 

  23. Subhawong TK, Eng J, Carrino JA, Chhabra A. Superolateral Hoffa's fat pad edema: association with patellofemoral maltracking and impingement. AJR Am J Roentgenol. 2010;195(6):1367–73.

    Article  PubMed  Google Scholar 

  24. Post WR, Teitge R, Amis A. Patellofemoral malalignment: looking beyond the viewbox. Clin Sports Med. 2002;21(3):521–46, x.

    Google Scholar 

  25. Simmons E Jr, Cameron JC. Patella alta and recurrent dislocation of the patella. Clin Orthop Relat Res. 1992;(274):265–9.

  26. Ward SR, Terk MR, Powers CM. Patella alta: association with patellofemoral alignment and changes in contact area during weight-bearing. J Bone Joint Surg Am. 2007;89(8):1749–55.

    Article  PubMed  Google Scholar 

  27. Balcarek P, Jung K, Ammon J, Walde TA, Frosch S, Schuttrumpf JP, et al. Anatomy of lateral patellar instability: trochlear dysplasia and tibial tubercle-trochlear groove distance is more pronounced in women who dislocate the patella. Am J Sports Med. 2010;38(11):2320–7.

    Article  PubMed  Google Scholar 

  28. Wittstein JR, Bartlett EC, Easterbrook J, Byrd JC. Magnetic resonance imaging evaluation of patellofemoral malalignment. Arthroscopy. 2006;22(6):643–9.

    Article  PubMed  Google Scholar 

  29. Laurin CA, Levesque HP, Dussault R, Labelle H, Peides JP. The abnormal lateral patellofemoral angle: a diagnostic roentgenographic sign of recurrent patellar subluxation. J Bone Joint Surg Am. 1978;60(1):55–60.

    PubMed  CAS  Google Scholar 

  30. Keser S, Savranlar A, Bayar A, Ege A, Turhan E. Is there a relationship between anterior knee pain and femoral trochlear dysplasia? Assessment of lateral trochlear inclination by magnetic resonance imaging. Knee Surg Sports Traumatol Arthrosc. 2008;16(10):911–5.

    Article  PubMed  Google Scholar 

  31. Barrie HJ. The pathogenesis and significance of menisceal cysts. J Bone Joint Surg Br 1979;61-B(2):184–9.

    Google Scholar 

  32. Jans L, Ditchfield M, Jaremko JL, Stephens N, Verstraete K. MRI demonstrates the extension of juxta-articular venous malformation of the knee and correlates with joint changes. Eur Radiol. 2010;20(7):1792–8.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Yale University - Bridgeport Hospital, 267 Grant Street, Bridgeport, CT, 06610, USA

    Shrey K. Thawait

  2. Johns Hopkins Hospital, 600 North Wolfe Street, Baltimore, MD, 21287, USA

    Theodoros Soldatos, Gaurav K. Thawait, Andrew J. Cosgarea, John A. Carrino & Avneesh Chhabra

  3. Department of Radiology and Radiological Science, The Johns Hopkins Hospital, 601 North Caroline Street, JHOC 3262, Baltimore, MD, 21287, USA

    Avneesh Chhabra

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  1. Shrey K. Thawait
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  2. Theodoros Soldatos
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  3. Gaurav K. Thawait
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  4. Andrew J. Cosgarea
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  5. John A. Carrino
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  6. Avneesh Chhabra
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Correspondence to Avneesh Chhabra.

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Thawait, S.K., Soldatos, T., Thawait, G.K. et al. High resolution magnetic resonance imaging of the patellar retinaculum: normal anatomy, common injury patterns, and pathologies. Skeletal Radiol 41, 137–148 (2012). https://doi.org/10.1007/s00256-011-1291-3

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  • DOI: https://doi.org/10.1007/s00256-011-1291-3

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