Surgical anatomy of the medial patellofemoral complex

<h2>ABSTRACT</h2> Patellar instability is a common cause of knee dysfunction in young individuals. The medial patellofemoral complex (MPFC), comprising the medial patellofemoral ligament and medial quadriceps tendon femoral ligament (MQTFL), plays a crucial role in stabilizing the patella. The MPFC originates from the medial femur in a saddle region between the medial epicondyle, adductor tubercle, and medial gastrocnemius tubercle with an elongated, ribbon-like footprint. The anteromedial insertion of the MPFC is broad and variable, with fibers typically attaching to the proximal patella and deep quadriceps tendon. Its anatomic midpoint lies at the junction of the medial patella and quadriceps tendon, an important reference for reconstruction. In MPFC reconstruction, anatomic femoral and patellar/quadriceps fixation is critical to ensure optimal graft function and patient outcomes. Advancements in our understanding of the MPFC emphasize the importance of anatomic graft placement and highlight emerging surgical techniques. As recent anatomic, biomechanical, and clinical studies have refined our knowledge of the MPFC, we discuss an up-to-date review of its surgical anatomy and relevance to reconstruction techniques.